Neurological Short-Term Outcomes of a Cohort of Children Born to Zika Virus-Infected Mothers in Barcelona
Round 1
Reviewer 1 Report
Very good articles and subject is novel and interesting
Reviewer 2 Report
In this manuscript, Natàlia Romaní et al did a prospective observa-tional cohort study which was conducted from May 2016 to December 2021 at Hospital Universitari Vall d’Heb-ron in Barcelona, to describe early neurodevelopmental outcomes on prenatally ZIKV exposed children in a non-endemic ZIKV area. In this study, the authors monitored 152 newborns born to 150 mothers with confirmed or probable ZIKV infection during pregnancy. They described 2 cases of congenital ZIKV syndrome born from women with confirmed ZIKV infection, 5 cases of other potentially ZIKV-related outcomes and all of them showed normal birth cranial circumference and born to women probably infected by ZIKV. Their result showed a low prevalence of neurodevelopmental impairment in an asymptomatic children at birth in a non-endemic area and they recommend close follow-up by only primary care pediatricians, instead of pediatric specialists.
ZIKV is known to have teratogenic effect and maternal-fetal transmission is one of the transmission routes. This study, which was carried out on the prenatally exposed ZIKV infants born in non-endemic vector-borne ZIKV area, is very important to understand the neurodevelopmental outcomes of ZIKV exposure.
Comments:
Although there are some limitations or challenges in this study, such as short period for ZIKV RNA detection, cross reactivity in serological assays and lost of patients during following-up, the results from this study indicated potential outcome of ZIKV exposure on neurodevelopment and also beneficial to make decision on the strategies following-up for the ZIKV exposure children.
I recommend accepting this manuscript for publication.
Reviewer 3 Report
This is an interesting manuscript with a careful description of the clinical and neurological evolution of children born to 11 confirmed cases of gestational ZIKV infection + 139 cases of probable ZIKV infection. In the confirmed cases, two presented the typical phenotype of CZS. Interestingly in the probable cases, all were born with normal HC, but five developed OZPROs. This finding is reassuring, and I agree with the authors that the follow-up of such cases can be done by primary care pediatricians.