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How is COVID 19 transmitted?
Chinese case study suggests COVID-19 is not transmitted from pregnant mothers
to newborns
Finally, some good news has emerged about the novel coronavirus that has spread around the
world. Chinese professors report in the journal Frontiers in Pediatrics that it doesn’t appear that
the viral infection is transmittable from pregnant mothers to newborns at birth.
The study is the second out of China within the last month to find that mothers infected with
coronavirus disease 2019 (COVID-19) during pregnancy did not infect their babies.
Home » Featured News » Chinese case study suggests COVID-19 is not transmitted from
pregnant mothers to newborns
Chinese case study suggests COVID-19 is not transmitted from pregnant mothers
to newborns
Four babies born in a hospital in Wuhan, the epicenter of the novel coronavirus outbreak,
did not show signs of infection and remain healthy today. Image: Shutterstock
— By Peter Rejcek, Frontiers Science Writer
Please note: In response to the COVID-19 pandemic, Frontiers is publishing the latest
peer-reviewed research, evidence, and data to build and inform the wider scientific
response. Research articles should not be considered public health advice.
Finally, some good news has emerged about the novel coronavirus that has spread around the
world. Chinese professors report in the journal Frontiers in Pediatrics that it doesn’t appear that
the viral infection is transmittable from pregnant mothers to newborns at birth.
The study is the second out of China within the last month to find that mothers infected with
coronavirus disease 2019 (COVID-19) during pregnancy did not infect their babies.
Infants Born to Mothers with a New Coronavirus (COVID-19)

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All four mothers in the current study, which focused on the health of the newborns, gave birth at
Wuhan’s Union Hospital while infected. Wuhan in Hubei Province is believed to be the epicenter
of the current outbreak that has sickened more than 174,000 people worldwide and killed more
than 6,800 (current as of date of publication).
None of the infants developed any serious symptoms associated with COVID-19 such as fever
or cough, though all were initially isolated in neonatal intensive care units and fed formula.
Three of the four tested negative for the respiratory infection following a throat swab, while the
fourth child’s mother declined permission for the test.
One newborn did experience a minor breathing issue for three days that was treated by non-
invasive mechanical ventilation. Two babies, including the one with a respiratory problem, did
have body rashes that eventually disappeared on their own.
It’s impossible to conclude whether there’s a connection between these other medical issues
and COVID-19. “We are not sure the rash was due to the mother’s COVID-19 infection,” said
study co-author Dr. Yalan Liu at Huazhong University of Science and Technology. She also
works in the Department of Pediatric at Union Hospital.
All four infants remain healthy, and their mothers also fully recovered.
In the previous retrospective study on nine pregnant mothers infected with COVID-19,

researchers also found no evidence that the viral infection can pass to the child. All nine births
were done by cesarean section. Three of the four pregnancies in the current study were also
brought to term by C-section.
“To avoid infections caused by perinatal and postnatal transmission, our obstetricians think that
C-section may be safer,” Liu said. “Only one pregnant mother adopted vaginal delivery because
of the onset of the labor process. The baby was normal. Maybe vaginal delivery is OK. It needs
further study.”
In previous coronavirus outbreaks, scientists found no evidence of viral transmission from

mother to child, but SARS and MERS were both associated with “critical maternal illness,
spontaneous abortion, or even maternal death,” according to Liu.
Globally, an estimated 3.4 percent of reported COVID-19 cases have died, according to
the latest data from the World Health Organization. In comparison, seasonal flu generally kills
far fewer than 1 percent of those infected. However, COVID-19 does not appear to spread as
easily as influenza. Note that transmission and fatality rates are currently subject to change and
revision as more research is done on the virus.
The authors said further investigations into other aspects of potential COVID-19 infection in
newborns and children are needed. For example, the sensitivity of the current diagnostic test for
detecting the virus is about 71 percent, so they suggest evaluating its reliability in children.
Toward that end, the researchers are collecting additional samples from the newborns, including
placenta, amniotic fluid, neonatal blood and gastric fluid, among others, to detect possible
receptors for the virus.
COVID-19 spread is fueled by 'stealth transmission'
Cases of COVID-19 that fly under the radar — without being diagnosed — appear to fuel the
rapid spread of the disease.
Cases of the new coronavirus disease (COVID-19) that fly under the radar — without being
detected or diagnosed — may have fueled the rapid spread of the disease, according to a new
study.
The study found that people with COVID-19 who didn't get diagnosed, likely because they didn't
feel very sick, were the source of at least two-thirds of documented COVID-19 cases in China in
the early days of the outbreak.
"The explosion of COVID-19 cases in China was largely driven by individuals with mild, limited,
or no symptoms who went undetected," study co-author Jeffrey Shaman, a professor of
environmental health sciences at Columbia University Mailman School of Public Health, said in
a statement.
"Undetected cases can expose a far greater portion of the population to [the] virus than would
otherwise occur. … These 'stealth transmissions' will continue to present a major challenge to
the containment of this outbreak going forward," Shaman said.
For the study, published Monday (March 16) in the journal Science, the researchers developed
a computer model to simulate the spread of SARS-CoV-2, the virus that causes COVID-19,
among 375 cities in China, including Wuhan, where the outbreak began. For the model, they
combined data on reported infections with information on people's movements (obtained from
mobile phone data).
They estimated that, prior to the lockdown of Wuhan on Jan. 23, about 86% of all COVID-19
infections in China were undetected. In other words, for every confirmed case of COVID-19,
there were six undetected cases, according to The Washington Post. These undetected cases
were responsible for the majority of the disease spread prior to the lockdown, the researchers
said.
The findings have implications for COVID-19 spread in the rest of the world, as many countries
are behind on testing for the disease. The results suggest that the number of cases worldwide
could be five to 10 times higher than what has been reported, meaning the true number of
cases could be higher than 1.5 million, according to Quartz.
"We know this is just the tip of the iceberg," Shaman said at a press conference Monday (March
16), according to Quartz. "The question is how much of the iceberg is submerged. We can
argue about the exact number, but if you're not in a place where you're "not proactively looking
for people and testing, then the majority of infections will go undetected."
After China implemented the lockdown on Wuhan, officials were able to detect the majority of
cases, 65%, and reduce the spread of the disease.
The findings suggest "a radical increase in the identification and isolation of currently
undocumented infections would be needed to fully control SARS-CoV-2," the authors
concluded.

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Directions: Create themes with codes (as many as needed) based on the following

— By Peter Rejcek, Frontiers Science Writer

Infants Born to Mothers with a New Coronavirus (COVID-19)

In the previous retrospective study on nine pregnant mothers infected with COVID-19,

In previous coronavirus outbreaks, scientists found no evidence of viral transmission from

COVID-19 spread is fueled by 'stealth transmission'

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