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\begin{document}

\title{Investigation of SARS-CoV-2 RNA in Human Milk of 3 Mothers with
SARS-CoV-2}



\author[1]{TALAT KILIC}%
\author[2]{Yasemin Ersoy}%
\author[1]{Hilal Ermis}%
\author[2]{Funda Memisoglu}%
\affil[1]{Inonu University School of Medicine}%
\affil[2]{Inonu University Faculty of Medicine}%


\vspace{-1em}



  
  \date{May 26, 2024}


\begingroup
\let\center\flushleft
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\maketitle
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\selectlanguage{english}
\begin{abstract}
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a
extremely infectious disease, and the current outbreak has been declared
by WHO as a global public health threatening. Researches have showed
that transmission of SARS-CoV-2 is mainly from person to person via
airborne droplets. It is unclear whether SARS-CoV-2 can be shed into
human milk and transmitted to a child via breastfeeding. Here we
investigated SARS-CoV-2 RNA in breast-milk samples of three mothers with
SARS-CoV-2 and their infant. The human milk sample of one mother for
SARS-CoV-2 RNA was positive. By contrast, SARS-CoV-2 RNA was not
detected in human milk of two mothers.The throat swab sample was also
positive in the infant of the mother whose SARS-CoV-2 RNA was detected
in human milk. By contrast, throat swab of others infants was negative.
Because the mother with SARS-CoV-2 RNA detected in human milk sample is
not breastfeeding, the risk of contagion from the infant to the mother
is eliminated. To date, in the literature, the presence of SARS-CoV-2
RNA has only been detected in the breast milk of two mothers with
SARS-CoV-2. To the best of our knowledge, our case is third case with
SARS-CoV-2 RNA detected in human milk. On the other hand, this is first
case with SARS-CoV-2 RNA detected in human milk of mother who does not
breastfeed her infant.The existing data indicates that SARS-CoV-2 can be
rare transmitted through human milk.%
\end{abstract}%



\sloppy


\textbf{Investigation of SARS-CoV-2 RNA in Human Milk of 3 Mothers with
SARS-CoV-2}

Talat Kilic\textsuperscript{1},Yasemin Ersoy\textsuperscript{2}, Hilal
Ermis\textsuperscript{1}, Funda Memis\textsuperscript{2}

\textsuperscript{1} Department of Pumnonary Medicine, Faculty of
Medicine, Inonu University, TURKEY

\textsuperscript{2} Department of Infectious Diseases, Faculty of
Medicine, Inonu University, TURKEY

Corresponding author: Talat Kilic, Assoc.,Prof.,M.D

Department of Pulmonary Medicine, Faculty of Medicine, Inonu University,
Elaz\selectlanguage{polish}ığ \selectlanguage{english}Yolu 44.km ,Ye\selectlanguage{polish}ş\selectlanguage{english}ilyurt,Malatya,TURKEY

\textbf{@mail:\emph{talatkilic2013@gmail.com}}

\textbf{Absract}

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a
extremely infectious disease, and the current outbreak has been declared
by WHO as a global public health threatening. Researches have showed
that transmission of SARS-CoV-2 is mainly from person to person via
airborne droplets. It is unclear whether SARS-CoV-2 can be shed into
human milk and transmitted to a child via breastfeeding. Here we
investigated SARS-CoV-2 RNA in breast-milk samples of three mothers with
SARS-CoV-2 and their infant. The human milk sample of one mother for
SARS-CoV-2 RNA was positive. By contrast, SARS-CoV-2 RNA was not
detected in human milk of two mothers.The throat swab sample was also
positive in the infant of the mother whose SARS-CoV-2 RNA was detected
in human milk. By contrast, throat swab of others infants was negative.
Because the mother with SARS-CoV-2 RNA detected in human milk sample is
not breastfeeding, the risk of contagion from the infant to the mother
is eliminated. To date, in the literature, the presence of SARS-CoV-2
RNA has only been detected in the breast milk of two mothers with
SARS-CoV-2. To the best of our knowledge, our case is third case with
SARS-CoV-2 RNA detected in human milk. On the other hand, this is first
case with SARS-CoV-2 RNA detected in human milk of mother who does not
breastfeed her infant.The existing data indicates that SARS-CoV-2 can be
rare transmitted through human milk.

\textbf{Keywords:} Human milk; infant; SARS-CoV-2

\textbf{What's already known about this topic?}

It is unclear whether SARS-CoV-2 can be shed into human milk and
transmitted to a child via breastfeeding. To date, in the literature,
the presence of SARS-CoV-2 RNA has only been detected in the breast milk
of two mothers with SARS-CoV-2. In two cases, environmental
contamination or retrograde flow from an infected infant could not be
ruled out.

\textbf{What does this article add?}

Because the mother with SARS-CoV-2 RNA detected in human milk sample is
not breastfeeding, the risk of contagion from the infant to the mother
is eliminated. This is first case with SARS-CoV-2 RNA detected in human
milk of mother who does not breastfeed her infant.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a
extremely infectious disease, and the current outbreak has been declared
by WHO as a global public health threatening. Researches have showed
that transmission of SARS-CoV-2 is mainly from person to person via
airborne droplets .\textsuperscript{1,2} However, it can be throught
skin contac, faecal-oral transmission, and oculer surface
contact.\textsuperscript{3-5} Gold standard diagnostic method of
SARS-CoV-2 is the virus to be detected in nasopharyngeal swabs by a
reverse transcription real-time PCR (RT-qPCR). \textsuperscript{1,2} The
virus also can be detected in bronchoalveolar-lavage fluid, sputum,
saliva, faces, and urine. \textsuperscript{6,7} It is unclear whether
SARS-CoV-2 can be shed into human milk and transmitted to a child via
breastfeeding.

Here we investigated SARS-CoV-2 RNA in breast-milk samples of three
mothers with SARS-CoV-2 and their infants. All mothers were informed
about the study and gave informed consent. Necessary permission was
obtained from the health authority of our country (Republic of Turkey
Ministry of Health).

All mothers lives in the east of Turkey. At different times they were
admitted to our hospital. For the mothers, computed tomography (CT) scan
was not shown any abnormal finding. CT scans were not performed to
infants.

The mother 1 with 22-day newborn (infant 1) ise a 24-year-old woman. She
had brought a healthy baby through normal vaginal delivery. The newborn
and mother did not have any health problems during and after delivery.
She brought the infant to the emergency room due to high fever
(38,3\textsuperscript{o}C). The infant's throat swab was positive for
SARS-CoV-2. The mother has sore throat, fatigue, and light cough, with a
body temperature of 36.6 \textsuperscript{o}C. Blood tests of the mother
revealed normal. Her vital signs were stable with oxygen saturation of
97\% in room air. Her chest CT scan don't showed any abnormal findings.
Because the infant's throat swab was positive for SARS-CoV-2, the test
was also applied to the mother too. Also, her throat swab was positive.
The mother 1 and her infant were isolated in the same room of the
hospital.The mother 1 was evaluated as SARS-CoV-2 and received
hydroxychloroquine (2x400mg {[}first day{]}, 2x200 mg for 4 days
{[}oral,5days in total{]}), azithromycin (1x500mg {[}first day{]} ,1x250
mg for 4 days {[}oral,5 days in total{]}),and Enoksaparin sodyum (2x
0,6ml,sc) according to the interim national guide. On the 5th day of
hospitalization, throat swab sample of mother and baby for SARS-CoV-2
were negative. On the 6th day of hospitalization, breast milk was
collected with pumps and sterod into a sterile container\textbf{.} On
the same day, it was detected SARS-CoV-2 RNA in milk sample from mother
1. Because the nipple was sticky, the mother could not breastfeeding.
Because the mother is not breastfeeding, the risk of contagion from the
infant to the mother is eliminated. The mother 1 and her infant were
discharged as healthy on the 7th day of hospitalization. Moreover, the
mother 1 was reexamined 14 days after discharge, and no viral RNA was
detected in her breastmilk.

The mother 2 with 36-day infant (infant 2) ise a 26-year-old woman. She
had given birth with cesarean section\textbf{.} The newborn was healthy.
She has a history of bipolar disorder for 6 years and has been treated
with oral drugs. She did not use medicines for bipolar disorder during
pregnancy\textbf{.} She had breastfed her newborn for 4 weeks after
birth. She had used drug (Lithuril, Quetiapine, Haloperidol dekanoat)
for bipolar disorder. She was not breastfeeding for the past week
because of using drugs. She was admitted to the emergency room due to
her psychiatric complaints on the 36th postpartum. Because of cought and
sore throat, the throat swab sample for SARS-CoV-2 RNA was positive. By
contrast, throat swab of infant 2 was negative. Chest CT scan and all
laboratory parameters(cbc,crp,etc) were normal. Other findings of both
mother 2 and infant 2 are shown in table 1. She was discharged as
healthy on the 6th day of hospitalization.

The mother 3 with 120-day infant (infant 3) ise a 26-year-old woman. She
had brought a healthy baby through normal vaginal delivery. The mother 3
and her infant did not have any health problems during and after
delivery. She was breastfeeding. She was admitted to the emergency room
due to her complaints (sore throat, cought). Chest CT scan and all
laboratory parameters(cbc,crp,etc) were normal. Her throat swab sampled
for SARS-CoV-2 was positive. Throat swab of infant 3 was negative. Other
findings of both mother 3 and infant 3 are shown in table1. During the
14-day isolation, the mother 3 breastfeed her infant by wearing a
surgical mask. During this period, no health problems developed in the
infant 3. After the 14-day izolation, the throat swab of both mother 3
and infant 3 for SARS-CoV-2 were negative.

For breast milk collection, iodine was used to disinfect all patient's
breast. Breast milk was collected with pumps and sterod into a sterile
container. On the day of taking the samples, SARS-CoV-2 RNA was examined
in all breast milk samples. Following admission, two breast milk samples
from Mother 2 and 3 tested negative. By contrast, SARS-CoV-2 RNA was
detected in milk from mother 1. Additionally, throat swabs of infant 1
was positive. All test results of the SARS-CoV-2 RNA for mothers and
infnats were shown in table 1.

All throat swab and breast milk samples were evaluated in our center
microbiology laboratory and by the same expert team.The presence of
SARS-CoV-2 RNA in the breast milk of the patient was investigated with a
reverse transcription real-time PCR (RT-qPCR) method with Bio-Speedy
RT-qPCR kit (Bioeksen R\&D Technologies Ltd., Turkey) targeting the
RNA-dependent RNA polymerase (RdRp) gene of the virus. The viral RNA was
extracted with Bio-Speedy vNAT kit (Bioeksen R \& D Technologies Ltd.,
Turkey) and amplification was performed in Rotor-Gene Q 5plex HRM device
(Qiagen, Belgium).

Human milk has numerous advantages for newborns, containing inactive
transmission of antibodies against several microbial
diseases.\textsuperscript{8} To date, in the literature, the presence of
SARS-CoV-2 RNA has only been detected in the breast milk of two mothers
with SARS-CoV-2. One of these case was reported by \selectlanguage{ngerman}\emph{Groß Ret al.}
in the lancet.\textsuperscript{9} The RT-qPCR for SARS-CoV-2 was
positive in the swab of this mother's newborn. Because this mother was
breastfeeding her newborn, the virus could be contaminated to the breast
through the secretions of the newborn. The other case was reported by
\emph{Wu Y at al} .\textsuperscript{10} The RT-qPCR for SARS-CoV-2 was
not done in the swab of this mother's newborn.\textsuperscript{10} While
RT-qPCR was positive in human milk of one(mother 1) of our cases, it was
found negative in the others (mother 2 and 3). RT-qPCR of SARS-CoV-2 was
positive in swabs of infant 1. Other mothers except the mother 1 were
breastfeeding until the diagnosis of SARS-CoV-2. Also,during the 14-day
isolation, the mother 3 breastfeed her infant by wearing a surgical
mask. During this period, no health problems developed in the infant 3.
After the 14-day izolation, the throat swab of both mother 3 and infant
3 for SARS-CoV-2 were negative.

To the best of our knowledge, this (mother 1 ) is third case with
SARS-CoV-2 RNA detected in human milk. On the other hand, this is first
case with SARS-CoV-2 RNA detected in human milk of mother who does not
breastfeed her infant(infant 1).

In a study by \emph{Liu W et al} , ten breast milk samples from mothers
were obtained after their first lactation and tested for SARS-CoV-2
RT-qPCR with negative results.\textsuperscript{11} In our study, in one
of the 5 milk samples taken from the mothers, RT-q PCR for SARS-CoV-2
was positive.The existing data indicates that SARS-CoV-2 can be rare
transmitted through breastmilk.

As in the example of mother 3 in our study, we think that the benefits
of breastfeeding may outweigh the risk of SARS-CoV-2 infection in
infants. In our cases, the mother 3 breastfeed her infant and SARS-CoV-2
was not transmitted from mother to infnat during the mother's illness.
Therefore, as recommended by the world health
organization\textsuperscript{12}, we recommend that mothers with
SARS-CoV-2 breastfeed their infants on condition that they wear a
surgical mask. Also, more studies are needed on whether SARS-CoV-2 is
excreted in breast milk and whether it is transmitted to the infant
through breast milk.

\textbf{Acknowledgements:} We would like to thank Yusuf Yakupogullar\selectlanguage{polish}ı
\selectlanguage{english}(M.D., Prof.),and Bar\selectlanguage{polish}ı\selectlanguage{english}s Otlu (PhD.,Prof.) from the microbiology
department ,and Yasar Bay\selectlanguage{polish}ı\selectlanguage{english}nd\selectlanguage{polish}ı\selectlanguage{english}r (M.D.,Prof.) from department of infection
diseases. Also, we thank all the medical staff members involved in
treating those women and their infants.

\textbf{Conflict of Interest.} The authors have no conflict of interest
to declare. This work has not been supported by grant from any funding
agency in the public, commercial, or not-for-profit sectors.

\textbf{References}

1. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia
associated with the 2019 novel coronavirus indicating person-to-person
transmission: a study of a family cluster. Lancet. 2020
Feb;395(10223):514--23.

2. Ghinai I, McPherson TD, Hunter JC, et al. First known
person-to-person transmission of severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) in the USA. Lancet {[}Internet{]}. 2020 Mar
13.

3. Amodio E, Vitale F, Cimino L, et al. Outbreak of Novel Coronavirus
(SARS-Cov-2): First Evidences From International Scientific Literature
and Pending Questions.
2020;2:1--8.\emph{https://doi.org/10.3390/}healthcare8010051.

4. Zhang H, Kang Z, Gong H, et al. The digestive system is a potential
route of 2019-nCov infection: a bioinformatics analysis based on
single-cell transcriptomes. BioRxiv.
2020.\emph{https://doi.org/10.1101/2020.01}. 30927806.

5. Lu C, Liu X, Jia Z. 2019-nCoV transmission through the ocular surface
must not be ignored. Lancet.
2020;395:e39.\emph{https://doi.org/10.1016/S0140-6736(20)30313-5}.

6. Young BE, Ong SWX, Kalimuddin S, et al. Epidemiologic Features and
Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA
{[}Internet{]}. 2020 Mar 3; Available from:
http://www.ncbi.nlm.nih.gov/pubmed/32125362

7.To KK, Tak O, Tsang Y, et al. Consistent detection of 2019 novel
coronavirus in saliva. Clin Infect Dis
2020:13.https://doi.org/10.1093/cid/ciaa149. Epub ahead of print.

8. Hanson LA. Breastfeeding provides passive and likely longlasting
active immunity. Ann Allergy Asthma Immunol. 1998;81:523--33. quiz 33-4,
37.

9. Gro\selectlanguage{ngerman}ß R,Conzelmann C, Müller JA,et al. Detection of SARS-CoV-2 in
human breastmilk.The Lancet.2020; 395:1757 1758. https: // doi.org
/10.1016 /S0140-6736(20)31209-5.

10. Wu Y, Liu C, Dong L, et al. Coronavirus disease 2019 among pregnant
Chinese women: case series data on the safety of vaginal birth and
breastfeeding {[}published online ahead of print, 2020 May 5{]}. BJOG.
2020;10.1111/1471-0528.16276. doi:10.1111/1471-0528.16276

11. Chen L, Li Q, Zheng D, et al. Clinical Characteristics of Pregnant
Womenwith Covid-19 in Wuhan, China. Correspondence.N Engl J Med. April
17, 2020. DOI: 10.1056/NEJMc2009226

12.Clinical Management of COVID-19:\selectlanguage{polish}İ\selectlanguage{english}nterim guidence. World Health
Organization. interim guidance.27 May 2020.
WHO/2019-nCoV/clinical/2020.5

\textbf{Table I: Clinical Characteristics of the Mothers with SARS-CoV-2
Confirmed by RT-PCR and Their Infants}\selectlanguage{english}
\begin{longtable}[]{@{}lllllll@{}}
\toprule
\begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Mother 1\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Infant 1\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Mother 2\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Infant 2\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Mother 3\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
Infant 3\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
24 y\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
22 d\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
26 y\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
36 d\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
26y\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
120 d\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Signs of infection\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Sore throat, fatigue,light cough\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Fever\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cough, fatigue\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
sore throat, cought\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Coexisting conditions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Bipolar disorder\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
CT scan test finding\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
ND\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
ND\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
ND\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
ND\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Contact with patients\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Throat swab RT-qPCR\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pozitif\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pozitif\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pozitif\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Negatif \textsuperscript{a}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pozitif\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Negatif \textsuperscript{a}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Human milk RT-qPCR\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Pozitif\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Negatif \textsuperscript{a}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Negatif \textsuperscript{a}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textbf{Mother--infant contact}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Immediate separation Breastfeeding\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No No\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Yes No\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No Yes\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Mode of delivery\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
vaginal\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Caesarean\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Vaginal\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Hospital stay days\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
7\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
6\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Not hospitalized\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Not hospitalized\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Not hospitalized\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Any severe complications\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textbf{Treatment}\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Supportive treatment\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Hydroxychloroquine\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Azithromycin\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Yes\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Antiviral agent\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Intensive care unit\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Mechanical ventilation\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
No\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

ND: Not done. \textsuperscript{a} Two RT-qPCR specimens examined at
24-hour intervals are negative.

\textbf{Hosted file}

\verb`Table I.docx`  available at \url{https://authorea.com/users/359377/articles/481413-investigation-of-sars-cov-2-rna-in-human-milk-of-3-mothers-with-sars-cov-2}

\selectlanguage{english}
\FloatBarrier
\end{document}

