COVID-19 in Pregnant Women, Maternal-Fetal Involvement, and Vertical Mother-to-Child Transmission: A Systematic Review

Updates on Auditory Outcomes of COVID-19 and Vaccine Side Effects: An Umbrella Review

PURPOSE

This umbrella review synthesizes and discusses systematic reviews (SRs) and meta-analyses (MAs) on auditory outcomes associated with COVID-19 infection and vaccination side effects. It is innovative in offering a comprehensive synthesis of evidence across adults and infants while summarizing vaccine-related auditory side effects.

METHOD

This literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, with no restrictions on population age or symptom severity. Four electronic databases were searched from their inception to October 2024. The Assessment of Multiple Systematic Reviews 2 checklist and Risk of Bias in Systematic Reviews tool were used to assess the quality of evidence and the risk of bias.

RESULTS

The systematic search identified 534 articles, narrowed down to 14 SRs following a full-text review: Nine focused on auditory outcomes of COVID-19; two, on outcomes in infants born to mothers infected during pregnancy; and three, on the auditory side effects of vaccination. A random-effects model revealed significantly high pooled estimates of hearing loss (5.0%, 95% CI [1.0, 9.0], p < .012, three MAs, N = 21,932) and tinnitus (13.5%, 95% CI [5.9, 21.1], p ≤ .001, four MAs, N = 36,236) in adults. However, current evidence in nonhospitalized patients indicates that auditory symptoms often improve after recovery. Studies also show a low rate of hearing loss in infants whose mothers contracted COVID-19 during pregnancy. Similarly, whereas COVID-19 vaccination has been linked to hearing loss and tinnitus, these effects are rare, and most patients experience improvement within weeks to months.

CONCLUSIONS

Evidence suggests a significantly high rate of hearing loss and tinnitus associated with COVID-19 in adults, although auditory symptoms remain rare in newborns and following vaccination. However, caution is warranted due to limitations and variability across the studies.

Special Issue "Latest Research in Post-COVID (Long COVID): Pathological and Treatment Studies of Sequelae and Complications"

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pathogen provoked the most unprecedented sanitary outbreak of the current century by causing coronavirus disease 2019 (COVID-19), which has led to approximately 775 million confirmed cases and more than 7 million deaths globally [...].

Does COVID-19 Infection during Pregnancy Increase the Appearance of Congenital Gastrointestinal Malformations in Neonates?

BACKGROUND

COVID-19 was an infection that was capable of bringing the entire world to a standstill position within a period of days to months. Despite the advancements in the medical sector, the contagion was difficult to control and costed the lives of millions of people worldwide. Many short- and long-term effects are witnessed even to date in people that contracted the disease. Pregnant females had to suffer not only the devastating effects of the virus, but also the psycho-social impact of the lockdown. The impact of COVID-19 infection during pregnancy causing decreased antenatal care or hypoxemic episodes due to severe respiratory distress and whether it could lead to the appearance of congenital gastrointestinal malformation in neonates is still unclear. The aim of our study was to analyze if COVID-19 infection during pregnancy could increase the incidence of gastric malformations in neonates born from these women.

MATERIALS AND METHODS

We sifted the files of all neonates admitted into our hospital between January 2022 and December 2022, and based on inclusion and exclusion criteria, we included the cases having gastrointestinal congenital malformations during the COVID-19 pandemic. We performed a single-center, retrospective, observational descriptive study. We further divided the patients based on the anatomical location of the malformation. We also took down details of the evolution of pregnancy and whether the mother had contracted a SARS-CoV-2 infection during the pregnancy. Details regarding the Apgar score, days of intensive care admission, sex, and nutrition were the key findings studied.

RESULTS

A total of 47 neonates were found to have digestive anomalies, among which, based on the anatomical locations, the number of malformation cases found at the level of the esophagus were 15, while 16 occurred at the level of the pylorus; we found 12 cases of malformation of the duodenum, and four cases had malformation of the rectum. Out of these 47 neonates, 38.3% were females and 61.7% were males. A total of 58% were preemies, among which 9% had intra-uterine growth retardation (IUGR), and 42% were full-term newborns, among which 4% had intra-uterine growth retardation (IUGR). A total of 45% of the births were primiparous pregnancies and 55% were from multiparous females. A total of 14 mothers were found to have tested positive for COVID-19 during the course of pregnancy (p-value = 0.23); many had mild symptoms but were not tested.

CONCLUSIONS

COVID-19 can affect the wellbeing of the pregnant female and their fetus. Larger studies can help gain extensive knowledge as to whether COVID-19 also has the potential to result in congenital gastrointestinal anomalies in children born from COVID-19 positive mothers. In our study, only a few infants born with this pathology were found to be born from COVID-19 positive mothers. Hence, it is difficult to conclude or exclude a direct correlation between the infection and the congenital malformations.

Stress of Prematurity in the Experience of the COVID-19 Pandemic-Current State of Knowledge

Stress is a process that triggers various physiological, hormonal and psychological mechanisms in response to a threat, which significantly affects the health of an individual. The COVID-19 pandemic introduced a lot of social changes that required constant adaptation to unfavorable conditions. The aim of the study was to assess the impact of stress related to this pandemic on pregnant women, mothers of premature infants and their families, and on obstetric complications, particularly preterm birth. A comprehensive literature review was performed using electronic databases such as Pubmed, Science Direct and Google Scholar. Keywords such as: "prematurity"; "pregnancy"; "stress"; "COVID-19" and various combinations of the above were used. Maternal stress and anxiety increase the levels of corticotropin-releasing hormone (CRH) in the placenta, which in turn affects the incidence of preterm birth and many other related maternal and neonatal complications. In addition, it was found that SARS-CoV-2 infection may increase the risk of this phenomenon. The COVID-19 pandemic has adversely affected preterm birth rates and the mental health of mothers of preterm infants, exacerbating their negative experience of having a premature baby. More research is needed to demonstrate the long-term effects of COVID-19 stress on prematurity.

Children's SARS-CoV-2 Infection and Their Vaccination

SARS-CoV-2, a novel coronavirus, causes respiratory tract infections and other complications in affected individuals, and has resulted in numerous deaths worldwide. The unprecedented pace of its transmission worldwide, and the resultant heavy burden on healthcare systems everywhere, prompted efforts to have effective therapeutic strategies and vaccination candidates available to the global population. While aged and immunocompromised individuals form a high-risk group for COVID-19 and have severe disease outcome, the rate of infections among children has also increased with the emergence of the Omicron variant. In addition, recent reports of threatening SARS-CoV-2-associated complications in children have brought to the forefront an urgent necessity for vaccination. In this article, we discuss the current scenario of SARS-CoV-2 infections in children with a special focus on the differences in their immune system response as compared to adults. Further, we describe the various available COVID-19 vaccines, including the recent bivalent vaccines for children, in detail, intending to increase willingness for their acceptance.