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Relationship between anti-SARS-CoV-2-specific antibodies in human breast milk following SARS-CoV-2 infection during pregnancy: a prospective cohort study
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  • Irene Fernández Buihgas,
  • Nieves Rayo,
  • Julia Cuesta Silos,
  • Berta Serrano,
  • Olga Ocón-Hernández,
  • Bo Wah Leung,
  • Juan Luis Delgado Marín,
  • David Sanchez-Nieves,
  • Silvia Valle Covarrubias,
  • Laura de Miguel,
  • Aroa Silgado,
  • Ramón Pérez Tanoira,
  • Valeria Rolle,
  • BELEN BSM SANTACRUZ MARTIN,
  • Liona Poon,
  • Mar Gil Mira
Irene Fernández Buihgas
Hospital Universitario de Torrejon

Corresponding Author:ifbuhigas@torrejonsalud.com

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Nieves Rayo
Hospital Universitario de Torrejón
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Julia Cuesta Silos
SYNLAB Diagnosticos Globales SAU
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Berta Serrano
Vall d'Hebron University Hospital
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Olga Ocón-Hernández
Hospital Universitario San Cecilio
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Bo Wah Leung
The Chinese University of Hong Kong
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Juan Luis Delgado Marín
Hospital Clinico Universitario Virgen de la Arrixaca
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David Sanchez-Nieves
Hospital Universitario Principe de Asturias
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Silvia Valle Covarrubias
Hospital Universitario de Torrejon
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Laura de Miguel
SYNLAB Diagnósticos Globales SAU
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Aroa Silgado
Hospital Universitari Vall d'Hebron
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Ramón Pérez Tanoira
Hospital Universitario Principe de Asturias
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Valeria Rolle
Instituto de Investigación Sanitaria del Principado de Asturias
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BELEN BSM SANTACRUZ MARTIN
Hospital Universitario de Torrejon
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Liona Poon
The Chinese University of Hong Kong
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Mar Gil Mira
Universidad Francisco de Vitoria Facultad de Ciencias de la Salud
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Abstract

Objective: To determine the presence of anti-SARS-CoV-2 antibodies in colostrum and mature milk in women who had SARS-CoV-2 infection during pregnancy or at delivery; to investigate the correlation between anti-SARS-CoV-2 antibodies in milk with antibody in maternal blood, severity of infection and time-interval from active illness; and to evaluate immunoglobulin evolution from colostrum to mature milk. Design: prospective cohort-study Setting: six hospitals in Spain and Hong-Kong. Sample: pregnant women with confirmed SARS-CoV-2 infection during pregnancy or at delivery. Methods: Colostrum and mature milk were collected by manual expression with strict contact precautions. Colostrum samples were tested with rRT-PCR-SARS-CoV-2 and both, maternal milk and serum were tested against SARS-CoV-2 specific immunoglobulin M, A and G reactive to receptor binding domain of SARS-CoV-2 spike protein-1. Results: All rRT-PCR-SARS-CoV-2 tested negative. IgA and IgG were present in 111/135 (82.2%) and 2/135 (1.5%) colostrum samples and 27/81 (33.3%) and 0/81 mature milk samples, respectively. Concentrations of immunoglobulins were not associated with the timing of infection but women with SARS-CoV-2 pneumonia had higher levels of IgA and IgG in colostrum than those who were asymptomatic or had mild symptoms. Conclusion: No SARS-CoV-2 virus was found in human milk, however, high levels of antibodies were found in colostrum, specially IgA, irrespective of the time of infection. All women should be encouraged to breastfeed, undertaking strict contact precautions when there is active disease. Funding: Spanish Government grant (Instituto de Salud Carlos III: COV20/00188). Synlab Diagnostics’ Globales (Madrid, Spain). Perkin Elmer.