Early Research Finds Coronavirus May Be Less Harmful for Children, Pregnant Women

• A new study provides a first look at how the respiratory illness affects pregnancies.
• The study evaluated nine pregnant women between the ages of 26 and 40 who were diagnosed with pneumonia caused by COVID-19.
• The most notable finding was that the virus was not passed from the mother to the fetus in the womb.

The new coronavirus has been spreading swiftly across the Hubei Province in China since it first appeared late December, quickly infecting over 60,000 people across 25 countries.

And though the coronavirus (aka COVID-19) can spread readily between humans — it’s estimated each sick person spreads it to two others — early evidence shows very few children have been diagnosed with the new coronavirus.

There may be a chance that kids have a lower risk of getting sick.

How the virus may affect newborns

Additionally, new research out of Wuhan, China, suspects that the virus does not pass from pregnant women to fetuses during pregnancy.

Though the new study, published in The Lancet Wednesday, was small and evaluated only nine pregnant women, it provides a first look at how the respiratory illness affects pregnancies.

The paper comes after a newborn whose mother had COVID-19 tested positive for the infection just 36 hours after being born.

The news prompted scientists to determine if COVID-19 can be passed to a fetus in the womb.

“It appears that the transmission routes do not include amniotic fluid, cord blood, or breast milk, all of which may be routes for a vertical transmission,” the study’s co-author Wei Zhang, an associate professor of preventive medicine at Northwestern University Feinberg School of Medicine, told Healthline.

That said, it’s not clear how the virus affects women in the early stages of pregnancy as this study only looked at those in their third trimester.

Women who are infected with the coronavirus will likely need to be isolated from their newborns after birth to avoid infecting them via close contact, Zhang added.

Pregnant mothers don’t seem to pass it on to fetuses

The study evaluated nine pregnant women between the ages of 26 and 40 who were diagnosed with pneumonia caused by COVID-19.

All of the women were in their third trimester at the start of the study, and successfully gave birth via cesarean delivery, commonly referred to as cesarean section (C-section).

The samples of amniotic fluid, cord blood, breast milk, and neonatal throat swabs were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), all of which tested negatively.

The most notable finding was that the virus was not passed from the mother to the fetus in the womb.

Additionally, pregnant women didn’t appear to have any clinical differences in how their illness progressed compared to the general population.

All women were in their third trimester, so it’s unknown how those in their first or second trimesters would respond to the infection.

Because the women all gave birth via a cesarean delivery, it’s unclear whether the virus could be transmitted to the baby during a vaginal birth.

The likelihood of that would largely depend on how the virus spreads.

If the virus spreads through airborne droplets, then the risk of transmission would be the same with cesarean deliveries and vaginal births, according to Dr. Jennifer Wu, an OB-GYN at Lenox Hill Hospital.

“If the viral infection is spread through blood or body fluids like HIV, then transmission rates drop with cesarean section,” Wu said.

Though the evidence here is promising, the researchers point out that the study is small and more research is necessary before they can conclude if intrauterine infection is possible or not.

SARS also didn’t spread to fetuses

These findings are similar to what was observed with severe acute respiratory syndrome (SARS, or SARS-CoV-1) around 2003.

According to the researchers, there was no evidence that pregnant women could spreads SARS to their fetuses either.

“These viruses do not tend to pass to the fetus due to the placenta and amniotic fluid sac protecting the fetus. Even in mothers with sepsis or bacteria in the bloodstream, the fetus is usually unaffected,” Wu said.

There do appear to be some key differences between SARS and COVID-19.

Pregnant women with SARS experienced more maternal and neonatal complications, including miscarriage, preterm delivery, and intrauterine growth restriction — amongst others.

This new study showed that pregnant women infected with COVID-19 didn’t have the same complications or negative outcomes, suggesting that the new coronavirus may cause a milder infection.

But it’s still too soon to know for certain how COVID-19 can affect pregnancies.

Pregnant women are immunosuppressed due to the changes they go through during pregnancy, which by default puts them more at risk.

Past evidence shows that pregnant women are more likely to experience more complications and be admitted to the hospital with other respiratory infections, including the flu and SARS.

Pneumonia is also a huge concern for pregnant women, according to Dr. Mike Sevilla, a practicing family physician in Salem, Ohio.

“Pneumonia in pregnant women is associated with significant maternal and fetal morbidity,” Sevilla said, adding that about a quarter of pregnant women with pneumonia will need to be hospitalized.

Until we have more answers, it’s crucial to continue paying special attention to pregnant women infected with COVID-19, who could very well have a greater risk of complications and negative birth outcomes.

“The experience with SARS-CoV-1 has taught us a lot, but more research has to be done specifically on this new SARS-CoV-2 before definitely conclusions and subsequent policy decisions can be made,” Sevilla said.

The infection appears less severe in children

Very few children have been infected with the new coronavirus. And those who test positively for COVID-19 seem to experience milder symptoms compared to older people.

A report published in JAMA last week found that most people infected with the coronavirus were between 49 to 56 years old.

Most of the patients also had an underlying illness, so the severity of the disease may depend on the person’s overall health leading up to the infection.

“We also know that in those reported who are infected, many have chronic medical conditions like diabetes, high blood pressure, and cardiovascular disease,” Sevilla said.

It’s still too early to say if children do in fact have a lower risk, but we have seen this phenomenon with other infectious diseases.

For example, children under 12 who were diagnosed with SARS experienced milder symptoms and fewer hospitalizations compared to adults.

Children diagnosed with Middle East respiratory syndrome (MERS) also had a lower mortality rate than adults, and generally experienced milder symptoms.

One paper evaluating MERS found that children with comorbidities experienced more severe respiratory symptoms compared to the children who were healthy.

We’re still in the very early stages of researching the new coronavirus. Until we have more evidence, no definite conclusions can be made about how the new coronavirus plays out in pregnant women and children.

“The situation with regards to the SARS-CoV-2 virus and the COVID-19 illness is constantly changing, and we are learning more every day,” Sevilla said.

The bottom line

New research on the new coronavirus suggests that the virus does not pass from pregnant women to fetuses during pregnancy. The women in the study were all in their third trimesters and gave birth via cesarean delivery, so it’s unclear how the coronavirus can be transmitted in early pregnancies or via vaginal birth.

Until we have more answers, researchers say it’s crucial to continue paying special attention to pregnant women infected with COVID-19, who could have a greater risk of complications and negative birth outcomes.

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