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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(03): 207-215
DOI: 10.1055/s-0040-1722256
Systematic Review

Vertical Transmission of SARS-CoV-2: A Systematic Review

Transmissão vertical do SARS-CoV-2: Revisão sistemática
Ionara Diniz Evangelista Santos Barcelos 
1   Department of Obstetrics and Gynecology, Universidade Estadual do Oeste do Paraná, Cascavel, Paraná, PR, Brazil
,
Ivan Andrade de Araújo Penna 
2   Department of Maternal-Infant Care, Universidade Federal Fluminense, Niterói, Rio de Janeiro, RJ, Brazil
,
Adriana de Góes Soligo 
3   Private Clinic of Human Reproduction Dra. Adriana de Góes, São Paulo, SP, Brazil
,
Zelma Bernardes Costa 
4   Department of Obstetrics and Gynecology, Universidade Federal de Goiás, Goiânia, GO, Brazil
,
Wellington Paula Martins 
5   SEMEAR Fertilidade, Ribeirão Preto, São Paulo, SP, Brazil
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Abstract

Objective The evaluation of the available evidence on vertical transmission by severe acute respiratory syndrome coronavirus 2 (SARS-CoV)-2.

Data Sources An electronic search was performed on June 13, 2020 on the Embase, PubMed and Scopus databases using the following search terms: (Coronavirus OR COVID-19 OR COVID19 OR SARS-CoV-2 OR SARS-CoV2 OR SARSCoV2) AND (vertical OR pregnancy OR fetal).

Selection of Studies The electronic search resulted in a total of 2,073 records. Titles and abstracts were reviewed by two authors (WPM, IDESB), who checked for duplicates using the pre-established criteria for screening (studies published in English without limitation regarding the date or the status of the publication).

Data Collection Data extraction was performed in a standardized way, and the final eligibility was assessed by reading the full text of the articles. We retrieved data regarding the delivery of the potential cases of vertical transmission, as well as the main findings and conclusions of systematic reviews.

Data Synthesis The 2,073 records were reviewed; 1,000 duplicates and 896 clearly not eligible records were excluded. We evaluated the full text of 177 records, and identified only 9 suspected cases of possible vertical transmission. The only case with sufficient evidence of vertical transmission was reported in France.

Conclusion The risk of vertical transmission by SARS-CoV-2 is probably very low. Despite several thousands of affected pregnant women, we have identified only one case that has fulfilled sufficient criteria to be confirmed as a case of vertical transmission. Well-designed observational studies evaluating large samples are still necessary to determine the risk of vertical transmission depending on the gestational age at infection.

Resumo

Objetivo Avaliar a evidência disponível acerca da transmissão vertical do coronavírus da síndrome respiratória aguda grave 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2, em inglês).

Fontes de Dados Foi realizada uma busca eletrônica em 13 de junho de 2020 nas plataformas Embase, PubMed e “Scopus utilizando os seguintes termos de busca: (Coronavirus OU COVID-19 OU COVID19 OU SARS-CoV-2 OU SARS-CoV2 OU SARSCoV2) E (vertical OU pregnancy OU fetal).

Seleção dos Estudos A busca eletrônica resultou em um total de 2.073 registros. Títulos e resumos foram revisados por dois autores (WPM, IDESB), que verificaram a ocorrência de duplicidade e utilizaram critérios preestabelecidos para o rastreamento (estudos publicados em inglês sem limitações quanto à data ou à situação da publicação).

Aquisição dos Dados A extração de dados foi realizada de forma padrão, e a eligibilidade final foi definida poir meio da leitura do artigo completo. Foram coletados dados dos partos de casos com potencial transmissão vertical, bem como os principais achados e conclusões de revisões sistemáticas.

Síntese dos Dados Foram revisados os 2.073 registros; 1.000 duplicatas e 896 registros claramente não elegíveis foram excluídos. Avaliamos os artigos completos de 177 registros, e identificamos apenas 9 casos de potencial transmissão vertical. O único caso com evidência suficiente de transmissão vertical foi relatado na França.

Conclusão O risco de transmissão vertical pelo vírus SARS-CoV-2 é provavelmente muito baixo. Apesar de milhares de gestantes afetadas, identificamos apenas um caso que preencheu critérios suficientes para que fosse confirmado como um caso de transmissão vertical. Estudos observacionais bem desenhados que avaliem grandes amostras ainda são necessários para se determinar o risco de transmissão vertical, a depender da idade gestacional na infecção.

Keywords

vertical transmission - SARS-CoV-2 - COVID-19 - perinatal outcomes - maternal morbidity

Palavras-chave

transmissão vertical - SARS-CoV-2 - COVID-19 - resultados perinatais - morbidade materna


Publication History

Received: 12 October 2020

Accepted: 06 November 2020

Article published online:
15 April 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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