Nature: Deleterious Effects of Nervous System in the Offspring Following Maternal SARS-CoV-2 Infection

Photo Credit – CDC

#16,808

It’s been long established that influenza and pregnancy are a bad combination - one that can endanger both the mother and unborn child’s life – and that women are more susceptible to influenza while (and just after) they are pregnant. 

It is for this reason that the CDC encourages all pregnant women to get the flu shot (see Pregnant Women & Influenza (Flu)).

And over the years we've looked at numerous studies suggesting that the offspring whose mothers who were infected during their pregnancy may be at higher risk of a wide spectrum of psychological and developmental problems later in life.  A few examples include:

Pregnancy, Influenza & Elevated Psychosis Risks In Adult Offspring

JAMA Psych: Long-term Risk of Neuropsychiatric Disease After Exposure to Infection In Utero

Molecular Psy.: Increased Autism Risk Linked To Prenatal Fever

While COVID isn't influenza, it often presents with an influenza-like illness (including fever), and induces many of the same immune responses as the flu, along with possessing its own unique ability to provoke neurological manifestations (see CMAJ: Even Mild COVID-19 May Have Long-term Brain Impacts).

We've seen a number of studies, and articles, cautioning that we could see a post-pandemic wave of delayed neurological disorders; similar to what was observed in the decade following the 1918 pandemic (see The Lancet: COVID-19: Can We Learn From Encephalitis Lethargica?). 

Review Article: Parkinsonism as a Third Wave of the COVID-19 Pandemic?

J. Neurology: COVID-19 As A Potential Risk Factor For Chronic Neurological. Disorders

Given its apparent enhanced neurotropism (see Understanding the neurotropic characteristics of SARS-CoV-2), and its similarity (in some ways) to influenza, it makes sense that researchers would be concerned about potential long-term impacts on the developing fetus should a woman contract the virus during her pregnancy. 

And, based on the CDC's (admittedly incomplete) numbers, hundreds of thousands of women fall into that category. 

All of which brings us to a lengthy review article in Nature Translational Psychiatry that looks at the plausible mechanisms of SARS-CoV-2 infection, and maternal immune response, that could induce deleterious effects on the unborn child's nervous system.  

Effects that might not become fully apparent for years. 

Due to its length, I've only posted the link and a few excerpts.  Follow the link to read it in its entirety.  I'll return with a postscript after the break. 

Deleterious effects of nervous system in the offspring following maternal SARS-CoV-2 infection during the COVID-19 pandemic
Ruting Wang, Zifeng Wu, Chaoli Huang, Kenji Hashimoto, Ling Yang & Chun Yang

Abstract

During the Coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is universally susceptible to all types of populations. In addition to the elderly and children becoming the groups of great concern, pregnant women carrying new lives need to be even more alert to SARS-CoV-2 infection. Studies have shown that pregnant women infected with SARS-CoV-2 can lead to brain damage and post-birth psychiatric disorders in offspring. 

It has been widely recognized that SARS-CoV-2 can affect the development of the fetal nervous system directly or indirectly. Pregnant women are recommended to mitigate the effects of COVID-19 on the fetus through vaccination, nutritional supplements, and psychological support.

 

This review summarizes the possible mechanisms of the nervous system effects of SARS-CoV-2 infection on their offspring during the pregnancy and analyzes the available prophylactic and treatment strategies to improve the prognosis of fetal-related neuropsychiatric diseases after birth.

 

Conclusion

COVID-19 affects fetal neurological development through multiple pathways during the pregnancy, although most newborns born in a COVID-19 pandemic setting are not directly infected with SARS-CoV-2. We need to pay attention not only to the neurological symptoms of neonatal impairment at birth, but also to the neuropsychiatric symptoms during the growth, and therefore improving the prognosis by early intervention. There is still a need for extensive follow-up studies to determine whether the fetal damage will be continued in adulthood, and new-onset psychiatric symptoms will be developed in adulthood. Most importantly, it is essential to create a safer environment and provide great support for pregnant women and their offspring.

          (Continue . . . )

Although much of society seems determined to adopt a `COVID is mild' attitude, there remains much we don't know about its long-term impact. 

• `Long COVID' is accepted by the CDC and NIH as a real, and often serious, post-infection sequelae (see MMWR: Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years).

• Cardiologists have warned that heart inflammation during infection may lead to bigger cardiac problems down the road (see Nature: Long-term Cardiovascular Outcomes of COVID-19).

• And while its incidence is reduced by vaccination, we saw last month that Long COVID After Breakthrough SARS-CoV-2 Infection can still occur. 

Since COVID is likely to remain with us for years to come, and even with vaccination, repeated infections seem likely, we need figure out ways to minimize its impact, and prepare now to deal with its long-term consequences. 

Ignoring it won't make it go away.