# Lactoferrin and SIgA Concentrations in Human Milk of SARS-CoV–Infected Mothers—Polish Cohort Study

## TL;DR

This study found lower levels of lactoferrin and SIgA in the colostrum of mothers infected with SARS-CoV-2 compared to healthy mothers, suggesting possible immune compensation.

## Contribution

The study identifies potential compensatory roles of lactoferrin in SARS-CoV-2-infected mothers' colostrum and highlights differences in immune markers.

## Key findings

- Lactoferrin and SIgA concentrations were significantly lower in SARS-CoV-2-infected mothers compared to healthy controls.
- The Lf/Protein ratio was significantly higher in the infected group, suggesting a compensatory immune response.
- 75% of infected mothers showed positive anti-SARS-CoV-2 SIgA results, while 90% of healthy controls had negative results.

## Abstract

Background: Human milk (HM) provides critical immunological support to neonates, serving as a key component of passive immunity during early life. Objectives: The main aim of this cohort study was to compare the concentrations of lactoferrin (Lf), secretory immunoglobulin A (SIgA), C-reactive protein (CRP), and their ratios to total protein levels in the colostrum of postpartum women infected with SARS-CoV-2 and healthy controls. Methods: Colostrum samples (3–5 mL) were collected from 40 mothers (20 infected, 20 healthy) during the first wave of the COVID-19 pandemic in Poland. Concentrations of Lf, SIgA, and CRP were analyzed using ELISA, and total protein content was measured using the bicinchoninic acid assay (BCA). Results: The presence of specific anti-SARS-CoV-2 SIgA antibodies was assessed via cassette serological lateral flow detection tests. Significant differences were observed in Lf (p = 0.04) and SIgA (p = 0.03) concentrations, both lower in the COVID-19 group. Lactoferrin medians were 12.30 g/L (infected) and 14.95 g/L (healthy), and for SIgA: 9.15 g/L vs. 15.01 g/L, respectively. No significant difference was found in CRP levels. Interestingly, the Lf/Protein ratio was significantly higher in the infected group (p = 0.03), whereas the SIgA/Protein ratio did not differ. Furthermore, 75% of infected mothers had positive anti-SARS-CoV-2 SIgA results. These mothers also showed a higher Lf/Protein ratio. Among healthy controls, 90% had negative test results. Conclusions: These findings suggest a potential compensatory role of lactoferrin in the nonspecific immune response to SARS-CoV-2, though stress-related reductions in SIgA levels cannot be excluded.