SARS-CoV-2 RNA and antibody detection in breast milk from a prospective multicentre study in Spain

Objectives To develop and validate a specific protocol for SARS-CoV-2 detection in breast milk matrix and to determine the impact of maternal SARS-CoV-2 infection on the presence, concentration and persistence of specific SARS-CoV-2 antibodies. Design and patients This is a prospective, multicentre longitudinal study (April–December 2020) in 60 mothers with SARS-CoV-2 infection and/or who have recovered from COVID-19. A control group of 13 women before the pandemic were also included. Setting Seven health centres from different provinces in Spain. Main outcome measures Presence of SARS-CoV-2 RNA in breast milk, targeting the N1 region of the nucleocapsid gene and the envelope (E) gene; presence and levels of SARS-CoV-2-specific immunoglobulins (Igs)—IgA, IgG and IgM—in breast milk samples from patients with COVID-19. Results All breast milk samples showed negative results for presence of SARS-CoV-2 RNA. We observed high intraindividual and interindividual variability in the antibody response to the receptor-binding domain of the SARS-CoV-2 spike protein for each of the three isotypes IgA, IgM and IgG. Main Protease (MPro) domain antibodies were also detected in milk. 82.9% (58 of 70) of milk samples were positive for at least one of the three antibody isotypes, with 52.9% of these positive for all three Igs. Positivity rate for IgA was relatively stable over time (65.2%–87.5%), whereas it raised continuously for IgG (from 47.8% for the first 10 days to 87.5% from day 41 up to day 206 post-PCR confirmation). Conclusions Our study confirms the safety of breast feeding and highlights the relevance of virus-specific SARS-CoV-2 antibody transfer. This study provides crucial data to support official breastfeeding recommendations based on scientific evidence. Trial registration number NCT04768244.

Bibliographic Details

Main Authors:	Bäuerl, Christine, Randazzo, Walter, Sánchez Moragas, Gloria, Selma Royo, Marta, Garcia-Verdevio, Elia, Martínez-Rodríguez, Laura, Parra-Llorca, Anna, Lerin, Carles, Fumadó, Victoria, Crovetto, Francesca, Crispi, Fátima, Pérez-Cano, Francisco J., Rodríguez, Gerardo, Ruiz-Redondo, Gema, Campoy, Cristina, Martínez-Costa, Cecilia, Collado, María Carmen
Other Authors:	Fundació La Marató de TV3
Format:	artículo biblioteca
Language:	English
Published:	BMJ Publishing Group 2021-08-20
Online Access:	http://hdl.handle.net/10261/250637 http://dx.doi.org/10.13039/100008666
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