SARS-CoV-2 vertical transmission in a twin-pregnant woman. A case report

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS- CoV-2) has affected millions of people around the world in the last years. Among susceptible patients, pregnant women seem to be prone to have serious complications. The possibility of SARS-CoV-2 vertical transmission represents one of the most debated topics in the literature, providing inconclusive results. We present a case of a confirmed vertical transmission in a monochorial diamniotic twin pregnancy complicated by a selective intrauterine growth restriction (sIUGR) and gestational diabetes. The analysis of different biological specimens identifies the presence of SARS-CoV2 genome in the umbilical cord blood of both twins and the placental histologic examination confirmed indirect signs of viral infection, supporting the hypothesis that a transplacental infection can occur. Despite the devastating impact that SARS-CoV2 has worldwide, neonatal infections have been infrequently reported but they can occur under certain biologic conditions. A deep knowledge of the biological mechanisms underlying the risk of SARS-CoV-2 vertical transmission might be useful to understand the pathophysiological bases and the possible long-term implication of a mother-to-child vertical transmission.