RT Journal Article
SR Electronic
T1 Titres and neutralising capacity of SARS-CoV-2-specific antibodies in human milk: a systematic review
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP fetalneonatal-2021-322156
DO 10.1136/archdischild-2021-322156
A1 Jia Ming Low
A1 Yue Wey Low
A1 Youjia Zhong
A1 Cheuk Yiu Charlotte Lee
A1 Ming Chan
A1 Nicholas Beng Hui Ng
A1 Zubair Amin
A1 Yvonne Peng Mei Ng
YR 2021
UL http://fn.bmj.com/content/early/2021/07/12/archdischild-2021-322156.abstract
AB Objective Synthesise evidence on production of SARS-CoV-2 antibodies in human milk of individuals who had COVID-19, and antibodies’ ability to neutralise SARS-CoV-2 infectivity.Design A systematic review of studies published from 1 December 2019 to 16 February 2021 without study design restrictions.Setting Data were sourced from PubMed, MEDLINE, Embase, CNKI, CINAHL and WHO COVID-19 database. Search was also performed through reviewing references of selected articles, Google Scholar and preprint servers. Studies that tested human milk for antibodies to SARS-CoV-2 were included.Patients Individuals with COVID-19 infection and human milk tested for anti-SARS-CoV-2 neutralising antibodies.Main outcome measures The presence of neutralising antibodies in milk samples provided by individuals with COVID-19 infection.Results Individual participant data from 161 persons (14 studies) were extracted and re-pooled. Milk from 133 (82.6%) individuals demonstrated the presence of anti-SARS-CoV-2 immunoglobulin A (IgA), IgM and/or IgG. Illness severity data were available in 146 individuals; 5 (3.4%) had severe disease, 128 (87.7%) had mild disease, while 13 (8.9%) were asymptomatic. Presence of neutralising antibodies in milk from 20 (41.7%) of 48 individuals neutralised SARS-CoV-2 infectivity in vitro. Neutralising capacity of antibodies was lost after Holder pasteurisation but preserved after high-pressure pasteurisation.Conclusion Human milk of lactating individuals after COVID-19 infection contains anti-SARS-CoV-2-specific IgG, IgM and/or IgA, even after mild or asymptomatic infection. Current evidence demonstrates that these antibodies can neutralise SARS-CoV-2 virus in vitro. Holder pasteurisation deactivates SARS-CoV-2-specific IgA, while high-pressure pasteurisation preserves the SARS-CoV-2-specific IgA function.All data relevant to the study are included in the article or uploaded as supplemental information. The data were extracted from the published literature. The details of all such literature used are included in the manuscript.