Can SARS-CoV-2 Be a Potential Cause of Microcephaly?
Gonca Keskindemirci, Alev Bakır Kayı, Öykü Özbörü Aşkan, Emine Gülbin GökçayDear Editor,
Microcephaly (MC) is defined as a head circumference with a standard deviation score (SDS) below -2 according to some experts and below -3 according to others (1-3). In our clinic, we use the criterion of head circumference below -2 SDS to define MC. MC can be classified as primary if present at birth, or as secondary if it develops postnatally (2, 4, 5). Several risk factors have been associated with MC, including genetic disorders, teratogenic exposure, maternal age, maternal phenylketonuria, and hypoxic-ischemic encephalopathy. Keskindemirci et al. also highlighted that socioeconomic factors may play a role in the risk of MC (6). Among these, maternal infections during pregnancy are the leading causes of microcephaly, with Rubella, Zika virus, and cytomegalovirus (CMV) being the most recognized infectious etiologies (2, 4).
The impact of COVID-19 on fetal development during pregnancy has not been fully elucidated. There are reports in the literature suggesting that SARS-CoV-2 infection during pregnancy may lead to complications (7). We read with interest the recent article by Edlow et al., which concluded that “COVID-19 exposure may be associated with neurodevelopmental changes and highlights the need for prospective investigation of outcomes in children exposed to COVID-19 in utero” (8). Moreover, Auger et al., in their time series analysis, observed an increased frequency of microcephaly during the COVID-19 pandemic period (9).
