Abstract
The COVID-19 pandemic is ongoing and we are still compiling new findings to decipher and understand SARS-CoV-2 infection during pregnancy. No reports encompass any conclusive confirmation of vertical transmission. Nevertheless, cases of fetal distress and multiple organ failure have been reported, as well as rare cases of fetal demise. While clinicians and scientists continue to seek proof of vertical transmission, they miss the greater point, namely the cause of preterm delivery. In this review, we suggest that the cause might not be due to the viral infection but the fetal exposure to maternal inflammation or cytokine storm that translates into a complication of COVID-19. This statement is extrapolated from previous experience with infections and inflammation which were reported to be fatal by increasing the risk of preterm delivery and causing abnormal neonatal brain development and resulting in neurological disorders like atypical behavioral phenotype or autistic syndrome. Given the potentially fatal consequences on neonate health, we highlight the urgent need for an animal model to study vertical transmission. The preclinical model will allow us to make the link between SARS-COV-2 infection, inflammation and long-term follow-up of child brain development.
Highlights
In December, 2019, several cases of pneumonia with an unknown cause were detected in Wuhan, China [1]
We described the utility of animal models, especially the nonhuman primate (NHP) models to study vertical transmission during COVID-19 to better understand if the fetus is prone to in utero infection by the SARS-CoV-2 or if its exposure to an inflamed environment through maternal immune activation (MIA) is sufficient to be fatal and could lead to neurodevelopment disorders in the long-term
These reports suggest that more studies for COVID-19 vertical transmissions need to be conducted and in this context, animal models would be very useful to univocally demonstrate whether SARS-CoV-2 can be transmitted to the fetus at birth
Summary
In December, 2019, several cases of pneumonia with an unknown cause were detected in Wuhan, China [1]. On February 11, 2020, the World Health Organization (WHO) named the disease resulting from this novel viral infection Coronavirus Disease-19 (COVID-19) [3]. We investigated the maternal and fetal complications, the possibility for vertical transmission, the effects of cytokine storm and inflammation on the fetus, and the potential neurological teratogenic effects of the virus during pregnancy that could cause additional neural complications in the brain development of the fetus. We described the utility of animal models, especially the nonhuman primate (NHP) models to study vertical transmission during COVID-19 to better understand if the fetus is prone to in utero infection by the SARS-CoV-2 or if its exposure to an inflamed environment through maternal immune activation (MIA) is sufficient to be fatal and could lead to neurodevelopment disorders in the long-term
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