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Front Immunol . Milk From Women Diagnosed With COVID-19 Does Not Contain SARS-CoV-2 RNA but Has Persistent Levels of SARS-CoV-2-Specific IgA Antibo

tetano

Editor, Senior Moderator
Front Immunol


. 2021 Dec 23;12:801797.
doi: 10.3389/fimmu.2021.801797. eCollection 2021.
Milk From Women Diagnosed With COVID-19 Does Not Contain SARS-CoV-2 RNA but Has Persistent Levels of SARS-CoV-2-Specific IgA Antibodies


Ryan M Pace[SUP] 1 [/SUP], Janet E Williams[SUP] 2 [/SUP], Kirsi M Järvinen[SUP] 3 [/SUP], Courtney L Meehan[SUP] 4 [/SUP], Melanie A Martin[SUP] 5 [/SUP], Sylvia H Ley[SUP] 6 [/SUP], Celestina Barbosa-Leiker[SUP] 7 [/SUP], Aline Andres[SUP] 8 9 [/SUP], Laxmi Yeruva[SUP] 8 9 [/SUP], Mandy B Belfort[SUP] 10 [/SUP], Beatrice Caffé[SUP] 4 [/SUP], Alexandra D Navarrete[SUP] 11 [/SUP], Kimberly A Lackey[SUP] 1 [/SUP], Christina D W Pace[SUP] 1 [/SUP], Alexandra C Gogel[SUP] 1 [/SUP], Bethaney D Fehrenkamp[SUP] 1 [/SUP], Miranda Klein[SUP] 3 [/SUP], Bridget E Young[SUP] 3 [/SUP], Casey Rosen-Carole[SUP] 3 [/SUP], Nichole Diaz[SUP] 3 [/SUP], Stephanie L Gaw[SUP] 12 [/SUP], Valerie Flaherman[SUP] 13 [/SUP], Mark A McGuire[SUP] 2 [/SUP], Michelle K McGuire[SUP] 1 [/SUP], Antti E Seppo[SUP] 3 [/SUP]



Affiliations

Abstract

Background: Limited data are available regarding the balance of risks and benefits from human milk and/or breastfeeding during and following maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Objective: To investigate whether SARS-CoV-2 can be detected in milk and on the breast after maternal coronavirus disease 2019 (COVID-19) diagnosis; and characterize concentrations of milk immunoglobulin (Ig) A specific to the SARS-CoV-2 spike glycoprotein receptor binding domain (RBD) during the 2 months after onset of symptoms or positive diagnostic test.
Methods: Using a longitudinal study design, we collected milk and breast skin swabs one to seven times from 64 lactating women with COVID-19 over a 2-month period, beginning as early as the week of diagnosis. Milk and breast swabs were analyzed for SARS-CoV-2 RNA, and milk was tested for anti-RBD IgA.
Results: SARS-CoV-2 was not detected in any milk sample or on 71% of breast swabs. Twenty-seven out of 29 (93%) breast swabs collected after breast washing tested negative for SARS-CoV-2. Detection of SARS-CoV-2 on the breast was associated with maternal coughing and other household COVID-19. Most (75%; 95% CI, 70-79%; n=316) milk samples contained anti-RBD IgA, and concentrations increased (P=.02) during the first two weeks following onset of COVID-19 symptoms or positive test. Milk-borne anti-RBD IgA persisted for at least two months in 77% of women.
Conclusion: Milk produced by women with COVID-19 does not contain SARS-CoV-2 and is likely a lasting source of passive immunity via anti-RBD IgA. These results support recommendations encouraging lactating women to continue breastfeeding during and after COVID-19 illness.

Keywords: COVID-19; IgA; SARS-CoV-2; antibodies; breastfeeding; human milk; immunoglobulins; passive immunity.
 
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