RAPID: Collaborative Research: COVID-19, human milk and infant feeding

RAPID：合作研究：COVID-19、母乳和婴儿喂养

• 批准号: 2031761
• 负责人: Sylvia Ley
• 金额: $ 1万
• 依托单位: Tulane University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=2031761&HistoricalAwards=false
• 关键词: RAPID; Collaborative; Research; COVID; 19

The COVID-19 pandemic has resulted in untold challenges to personal and public health, largely because scientists and clinicians know very little about the virus that causes it and how transmission occurs. Whereas respiratory droplets are known to be a major mode of transmission, it is very likely that there are other sources. One understudied possibility is transmission from mother to infant via breastfeeding. Although researchers know that some viruses can be passed from mother to infant in this fashion, almost nothing is known about SARS-CoV-2 (the virus that causes COVID-19). For this reason, there is substantial confusion as to whether breastfeeding is safe and/or beneficial when a mother is known to be infected. This study will provide fundamental information about this basic biological property of SARS-CoV-2, information that will be immediately usable by women, healthcare providers, and public policy makers. This study will investigate whether SARS-CoV-2 and anti-SARS-CoV-2 antibodies can be detected in breast milk produced by infected women. Results will provide needed information about potential spread of the disease between breastfeeding mothers and infants as compared to formula-feeding mothers and infants. This topic is urgent because women continue to give birth and breastfeed during the pandemic, and guidance is critically needed. The Broader Impacts of this project include both outreach to the public to inform breastfeeding mothers about breast-feeding choices, and education of an undergraduate and graduate student.Although respiratory droplets are a known source of SARS-CoV-2 transmission, other modes likely exist. One such possibility is SARS-CoV-2 vertical transmission during breastfeeding, but little is known about this type of transfer for any coronaviruses. For SARS-CoV-2, there are only a handful of studies that report analysis of milk produced by COVID-19+ women; all but three report no evidence of virus in milk. There is similarly limited research on the effects of maternal milk antibodies on infant immune responses and severity of symptoms. As a result, there is substantial confusion as to the risks and benefits of breastfeeding for SARS-CoV-2+ mothers. This proposed research is a longitudinal, repeated-measures study of 25 breastfeeding mothers and infants and 25 formula-feeding mothers and infants. Dyads will be recruited within 7 days of maternal COVID-19 diagnosis and followed for 2 months during which time milk and breast swabs will be repeatedly collected (from breastfeeding mothers) and analyzed for SARS-CoV-2 RNA using an RT-qPCR; milk will also be analyzed for SARS-CoV-2-specific antibodies. Stool samples will also be collected and analyzed to assess viral exposure/shedding; and dried blood spots collected and analyzed to assess viremia and antibody (IgG and IgA) titers. Results will immediately inform women, healthcare providers, and public policy makers regarding infant feeding choices during the postpartum period. This RAPID award is made by the Physiological and Structural Systems Cluster in the BIO Division of Integrative Organismal Systems, using funds from the Coronavirus Aid, Relief, and Economic Security (CARES) Act.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

COVID-19大流行给个人和公共健康带来了难以言喻的挑战，这主要是因为科学家和临床医生对导致该疾病的病毒以及传播方式知之甚少。虽然已知呼吸道飞沫是主要的传播方式，但很可能还有其他来源。一个未充分研究的可能性是通过母乳喂养从母亲传染给婴儿。虽然研究人员知道一些病毒可以通过这种方式从母亲传给婴儿，但对SARS-CoV-2（导致COVID-19的病毒）几乎一无所知。由于这个原因，当母亲被感染时，母乳喂养是否安全和/或有益的问题存在很大的混乱。这项研究将提供有关SARS-CoV-2的基本生物学特性的基本信息，这些信息将立即被妇女，医疗保健提供者和公共政策制定者使用。本研究将调查是否可以在受感染妇女的母乳中检测到SARS-CoV-2和抗SARS-CoV-2抗体。研究结果将提供必要的信息，说明与配方奶粉喂养的母亲和婴儿相比，母乳喂养的母亲和婴儿之间疾病的潜在传播。这一主题很紧迫，因为在大流行期间妇女继续分娩和母乳喂养，迫切需要指导。该项目的更广泛影响包括向公众宣传母乳喂养母亲的母乳喂养选择，以及对本科生和研究生的教育。虽然呼吸道飞沫是SARS-CoV-2传播的已知来源，但可能存在其他模式。其中一种可能性是SARS-CoV-2在母乳喂养期间的垂直传播，但对任何冠状病毒的这种类型的传播知之甚少。对于SARS-CoV-2，只有少数研究报告分析了COVID-19+妇女生产的牛奶;除三项研究外，所有研究都报告牛奶中没有病毒的证据。同样，关于母乳抗体对婴儿免疫反应和症状严重程度的影响的研究也很有限。因此，对于SARS-CoV-2+母亲母乳喂养的风险和益处存在很大的混淆。这项研究是一项纵向的重复测量研究，共有25名母乳喂养的母亲和婴儿以及25名配方奶粉喂养的母亲和婴儿参与。将在母亲COVID-19诊断后7天内招募二元组，并随访2个月，在此期间将重复收集乳汁和乳房拭子（来自母乳喂养的母亲），并使用RT-qPCR分析SARS-CoV-2 RNA;还将分析乳汁中的SARS-CoV-2特异性抗体。还将采集并分析粪便样本，以评估病毒暴露/脱落;采集并分析干血斑，以评估病毒血症和抗体（IgG和伊加）滴度。结果将立即通知妇女，医疗保健提供者和公共政策制定者关于产后期间婴儿喂养的选择。该RAPID奖项由BIO综合有机系统部门的生理和结构系统集群颁发，使用冠状病毒援助，救济和经济安全（CARES）法案的资金。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。