@article {Gee2021.05.27.446014, author = {Sarah Gee and Manju Chandiramani and Jeffrey Seow and Carlotta Modestini and Abhishek Das and Katie J Doores and Rachel M Tribe and Deena L Gibbons}, title = {The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate}, elocation-id = {2021.05.27.446014}, year = {2021}, doi = {10.1101/2021.05.27.446014}, publisher = {Cold Spring Harbor Laboratory}, abstract = {Despite extensive and ongoing studies of SARS-CoV-2 and evidence that pregnant women are at increased risk of severe COVID-19, the effect of maternal infection on the developing infant remains unclear. To determine the potential impact of exposure to SARS-CoV-2 in utero on the neonate, we have assessed the immunological status of infants born to mothers with confirmed SARS-CoV-2 infection during gestation. No evidence of vertical transmission of SARS-CoV-2 was observed, but transfer of maternal SARS-CoV-2 specific IgG to infants was apparent, although to a lesser extent in cases of active or recent maternal infection. Infants born to mothers with recent/ongoing infection had elevated circulating pro-inflammatory cytokines and enhanced percentages of innate immune cells compared to that seen in infants born to uninfected mothers. In tandem, higher frequencies of FOXP3+ regulatory T cells and circulating IL-10 demonstrated a further nuance to the neonatal effector response. Interestingly, cytokine functionality was enhanced in infants born to mothers exposed to SARS-CoV-2 at any time during pregnancy. This indicates that maternal SARS-CoV-2 infection influences in utero priming of the fetal immune system.Competing Interest StatementThe authors have declared no competing interest.}, URL = {https://www.biorxiv.org/content/early/2021/05/28/2021.05.27.446014}, eprint = {https://www.biorxiv.org/content/early/2021/05/28/2021.05.27.446014.full.pdf}, journal = {bioRxiv} }