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Triggered - does maternal COVID-19 program an exaggerated immune response in neonates?

Pediatric Research (2024)Cite this article

A Correction to this article was published on 19 January 2024

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The consequences of gestational coronavirus disease 2019(COVID-19) exposure on neonatal immunity are incompletely understood. While vertical transmission to the fetus is rare, maternal COVID-19 exposure can adversely impact the neonate by inducing placental pathology, or indirectly, via neonatal immune programming. To investigate the latter, Gilley et al. analyzed cytokine levels in cord blood mononuclear cells (CBMCs) obtained from neonates exposed to chorioamnionitis, gestational COVID-19, and unexposed controls. They observed that fetal exposure to maternal inflammation, by either SARS-CoV-2 infection or chorioamnionitis, exaggerated the pro-inflammatory cytokine response to neonatal bacterial pathogens in cultured CBMCs. While both chorioamnionitis and COVID-19 exposure exaggerated cytokine expression, there were differences in immune cell populations and cell-type specific responses. These interesting findings indicate that fetal exposure to inflammatory stimuli, even without fetal infection, results in changes in the neonatal immune cell phenotype and function leading to heightened immune activation. The results of this study differ from a trend towards a muted pro-inflammatory response seen in pediatric COVID-19, which is attributed to cause decreased disease severity. The mechanisms underlying neonatal immune programming, the timing and severity of maternal exposure in relationship to immune programming and long-term health consequences need to be explored in future studies.

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Funding

TB’s effort was partly supported by 5R01AI147778, VS’s effort was partly supported by (1R01 DK117296-05, 1R01 HL162937-01, VS).

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  1. Genomic Medicine Center, Children’s Mercy Kansas City, Kansas City, MO, USA

    Todd Bradley

  2. Division of Neonatology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Megan Tucker & Venkatesh Sampath

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Correspondence to Venkatesh Sampath.

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The original online version of this article was revised: the abstract of this Comment was inadvertently included as the first paragraph in the original article.

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Bradley, T., Tucker, M. & Sampath, V. Triggered - does maternal COVID-19 program an exaggerated immune response in neonates?. Pediatr Res (2024). https://doi.org/10.1038/s41390-023-03007-0

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