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So far more than 150 cases of immune system failure in human has been reported. Chronic Granulomatous Disorder (CGD) is a life-threatening and life-limiting condition and is an inherited genetic disorder in which phagocytes (Immune system cells eating microbes and destroy them) are not able to are not able to fight against microbes and hence those get involved with CGD are prone to get infected with some kinds of infectious and bacterial diseases. This disease is ranked as the second among immune system failure in Iran. Accumulation of immune system cells in the spot of infection, inflammation which is called granuloma, long lasting infections resisting to treatment, prevalence of self-defense diseases and chronic malignant are among different symptoms of this disease. Knowing the clinical symptoms can be of great help in suppressing this disease. 
Ali was one of those children who got infected with this disease at the age of 4 and was hospitalized in infection unit at one of Pediatric Hospitals. Here comes Ali’s story as his mother states.
“Since he was 4 months, he got involved with infectious diseases and had got hospitalized for a couple of times. This was genetically inherited to Ali since his cousin who is 7 months older than Ali suffered from this problem. Ali was our first child and I took special care of him in full love, but as the result of this disease I felt so anxious, in full disappointment. Regardless deep care I paid to him, he got infected very other time and had to be hospitalized. As an ultimate solution, his physicians found the solution in transplantation of bone marrow stem cells. Yet, to our great disappointment we realized that there was no match to Ali’s in bone marrow.”
 

Every cloud has a silver lining and it turns to be fine while you are in deep sorrow.
“As we were struggling for Ali’s survival and health condition, I found that I was pregnant and worst of I all I was informed by doctors that this disease can be transferred to my second child, who was a girl, as well. Since there was a probability of 50% of transmission of this problem, we decided to abort it; however, Ali’s doctor was sort of optimist to this issue and believed that there is another chance of 5o% in which the placenta is healthy and hence its cord blood stem cells can be applied for Ali’s treatment and transplantation purpose. That was why we refrained from abortion. My daughter Aylin, who is a 2-year girl with shiny eyes, was born in full birth and had a gift for his brother; her cord blood. Sparks of excitement and joy filled up our souls hearing that Aylin’s cord blood was in full match with those of Ali’s. Our trust in God even grew up finding out that all Aylin’s microbiologic blood tests showed no infection and she was thoroughly healthy in all aspects. Having performed all required laboratory tests, Ali was hospitalized in Pediatrics Hospital where he received her sister’s cord blood. Following the transplantation, he took medications which are stopped now. He has received his health in full and goes to school and has shown more talent than his peers. Holding up the classes virtually, due mainly to COVID-19 pandemic, Ali follows all his lessons as other classmates.
 
I would like to write my name
Ali is in grade one primary school this year. COVID-19 pandemic has turned the whole world into a chaos but there is nothing for Ali to be worried about since, like all other students, he takes part in virtual classes and handles all his assignment. He is a healthy, happy and hopeful boy studying his lessons enthusiastically and wishes to learn alphabets as soon as possible to write his name by his own.
We asked Ali about his class and school and he replied: “I love school and studying too much but right now we cannot make our presence in classes right now and I have to follow my lessons and teachers’ instructions through laptops. But I like to play with my friends and I also like to learn alphabets so that I can write my name both in Persian and English.”
 
When we asked about the hospital, he said: “Being confined to hospital is a tough time. But I am strong and told other children in hospital to be strong and eat well and enough and do not afraid of anything.:
When grow up, Ali wishes to become a police to catch the thieves. This cute boy states:” I love my sister too much and would like her to be a teacher in future.” 
 

 . Although the treatment did not use cord blood, the decision of the parents to enroll in a Community cord blood stem cell bank covered all the stem cell transplant related costs of their child’s medical care.  

It was just another day for Mr. Hitesh Agarwal from Surat, a city in India, when he was playing with his 3 months old daughter Shanaya and had an appointment for her regular check-up with the doctor. But little did he realize that this day was going to be different. It became traumatic and nightmarish when the doctor confirmed to him that his daughter had been diagnosed with Thalassemia Major, a critical blood disorder. Both mother and father were found to be carriers of this disease, a fact that was hitherto unknown to them. The best possible treatment for little Shanaya to survive, for her parents to see their dreams for their daughter stay alive, was a stem cell transplant. 
It was a decision they took at Shanaya’s birth that stood by them during this hour of crisis. "We were on cloud nine when she was born in 2018. Like most new-age parents, we too had planned for her healthy future well in advance by signing up for a Community Stem Cell Banking to bank our baby's cord blood. But little did we know the impact this decision would have on our lives," reminisces Mr. Hitesh Agarwal.
 As the parents came to grips with the situation at hand, Hitesh quickly went into action to explore options in stem cell treatment. He was advised by the doctor to check his blood to see if his stem cells could be a match for his child. As luck would have it, Hitesh and Shanaya were a full match on all the genetics required for a stem cell transplant - a medical miracle of sorts, since it is very rare for a parent and child to be a full match. The hospital swiftly planned the stem cell transplant to give the father’s cells to Shanaya, and the procedure was successfully done. The power of stem cells worked. Now Shanaya is treated and is reborn, giving new life to her parents dreams for their daughter.
 "As we stood there wondering how to make arrangements for the humongous bill, the cord blood bank came to our rescue. We were, of course, aware of their medical assistance program at the time of signup, where a customer is guaranteed monetary assistance of INR 20 lakhs to offset the transplant related expenses. However, we weren't sure it worked," pointed out Mr. Hitesh. 
Today, Shanaya gives an innocent smile of gratitude to her father. Hitesh responds emotionally with tears flowing out of his eyes, truly with satisfaction of fulfilling his responsibility of fatherhood. Now Hitesh can proudly say “I have given my blood to save you” to his daughter when she grows up. 

According to public relation, some total number of 18999 samples were received to the process department of RSCT out of which 17522 ones could meet all standard criteria to be cryopreserved. This means that more than 92% of the umbilical cord blood units delivered to RSCT have been stored successfully. Some of the samples are stored in two blood bags due to the high cell counts they hold of which the number rose up to 333 units in 2019. Taking into account the number of double-bag samples stored, we come to a total number of 17855 samples (94%) stored at RSCT and some number of 1477 ones (about 8%) which could not meet all standard criteria and hence were discharged from process and hence storage cycle. There are quite number of reasons leading to discharging of cord blood samples from process and storage cycle such as low volume of cord blood, low cell count (due probably to placenta age, physical conditions, pregnancy age, etc), microbiological contamination (which may include 3-5 %) and some more.
It should also be noted that out of total number of 18191 samples, some 15970 ones have been stored in 2017.

 stated:”Regardless the unusual conditions of the country which are caused as the consequences of Coronavirus pandemic, providing cord blood storage services have been represented to the parents and applicants in a proper way during April 2020 , leading to signing a number of 1800 contracts which shows a raise of 25% compared to its same time last year. Dr.Mozdgir also added:”There has been also an increase in number of contracts made in Tehran through April 2020, showing an increase of about 66% in a comparison with the same time last year.” Pointing to total number of 1438 contracts made through the year 2019, he stated that considering special conditions raised as the results of COVID-19, we expected a fall in the number of applications. However, thanks to gift of God and under the light of comprehensive team work and publicizing, we could take crucial steps toward banking some more samples than before.
He continued stating that observing some regulations such as personal protection among company staff and blood collectors  and also holding social distance both in Tehran office and other branches of company nationwide, we could step forward to achieving this rate of success in improving the number of samples. Among other steps taken, he pointed to providing self-protection equipment for staff and blood collectors, decreasing number of face to face registration through providing and facilitating internet registration systems, round-the-clock  consulting services and supports even to those who made their minds on storing their baby’s cord blood sample in the last minute  and some other facilities provided by RSCT played a crucial role in getting success in meeting the demands and increasing the number of applicants.
19 Provinces showed the best results in Aplril 2020
RSCT Manager fo Marketing and Sales said:”19 provinces showed a remarkable performance in April 2020 since their operation time including: Hormozgan, Central, Mazandaran, Golestan, Kermanshah, Kerman, Kordestan, Qazvin, Smnan, Zanjan, Khorasan Razavi, South Khorasan, Char Mahal Bakhtiari, Tehran, Boushehr, West Azerbaijan, Alborz and Ardebil.

Are pregnant women at increased risk for COVID-19?
 
 
The professional society of obstetricians in the United States, ACOG, says that the data available at this time does not indicate that pregnant women are at increased risk of catching COVID-191. However, when pregnant women do contract respiratory infections, they are known to be at greater risk for experiencing severe symptoms. Hence, pregnant women “should be considered an at-risk population for COVID-19”. If you are pregnant during the coronavirus pandemic, you should follow strict precautions to avoid exposure to COVID-19. If you are pregnant and suspect that you have COVID-19, you should tell your doctor immediately.
 It is important to point out that the novel coronavirus COVID-19 is not a flu virus. Nonetheless, the symptoms of COVID-19 are similar to flu and the way it spreads is similar to flu, so in this report we base part of our guidance on previous research about pregnancy and flu viruses. 
 

During pregnancy, changes occur in the immune system to prevent the mother’s body from recognizing her baby as foreign and attacking it. But these changes mean that pregnant women have lower immunity to disease. Pregnant women also have increased loads on their heart and lungs. A healthy woman that is pregnant has an increased risk of being hospitalized with the flu; during the first, second, and third trimester of pregnancy the risk of hospitalization increases by a factor of 1.7, 2.1, and 5.13. When the pregnant woman has preexisting health conditions, like diabetes or asthma, the increased risk factors are 2.9, 3.4, and 7.9 for the three trimesters3. 

Does having the flu during pregnancy influence pregnancy outcomes? 

If an expectant mother becomes severely sick with the flu, there is an increased risk of miscarriage or premature labor. A small study of 10 births in China found that maternal COVID-19 pneumonia at the time of birth was associated with fetal distress and premature labor. Again, if you are pregnant and suspect you have COVID-19, you should tell your doctor immediately. 

Can sick mothers transmit COVID-19 to their baby? 
 

While a baby is still in the womb, the placenta works to protect the baby against disease. The placenta is an amazing organ that allows antibodies to pass from the mother to the baby, but most of the time the placenta blocks diseases from crossing to the baby. 
In the case of ordinary influenza, aka the “flu”, a large hospital study found no evidence for trans-placental transmission of the infection from mother to baby. 
In the case of COVID-19, initial studies coming out of China suggest that the coronavirus may sometimes be transmitted from mother to baby, but it will take more studies of bigger patient groups to confirm this. The most often quoted study
 from Wuhan China looked at 33 babies born to mothers that were sick with the coronavirus. Three of these babies were diagnosed with COVID-19 as newborns, even though they were delivered via C-section. Despite suffering from fevers and pneumonia shortly after birth, all three babies recovered and tested negative for COVID-19 by age one week. 
After giving birth, a mother that is actively sick with COVID-19 can transmit the virus to her newborn through close contact. In that situation it is helpful for the mother pump her milk and have another caregiver feed and handle the baby until mom is recovered. 

Does cord blood contain COVID-19? 
 

To the best of our knowledge, the umbilical cord blood will not contain COVID-19, even if the mother is sick at the time of delivery. It is important to clarify that there is a difference between studies that look for COVID-19 disease transmission between mother and baby, versus studies that test for signs of COVID-19 in the cord blood; these are two separate topics. 
When a person is sick with a respiratory virus, it is very rare for the virus to appear in their blood. The patient’s blood will show antibodies to the virus, but not the virus itself. For this reason, the FDA does not recommend tests to screen asymptomatic blood donors for COVID-19. It is extremely unlikely for COVID-19 to appear in cord blood. 
A 2006 study sponsored by the American Red Cross is almost prescient in describing the current COVID-19 pandemic. The paper predicts that during a flu pandemic, donated blood will be safe, but there will be a blood shortage due to disruption of blood center operations. That is exactly what is happening now, and in response the FDA has relaxed their restrictions on blood donors. 
 
Further reassurance that COVID-9 does not appear in the umbilical cord blood or birth tissues comes from a study of nine births in Wuhan China. The nine mothers were all suffering from COVID-19 pneumonia, and their babies were delivered via C-section. While the babies were still in the sterile operating room, and before they had contact with their mothers, samples were collected of their amniotic fluid, cord blood, and neonatal throat swabs. Later the mother’s breastmilk was collected. All of these samples tested negative for COVID-19, using both the CDC test and the hospital’s in-house RT-PCR test. 
Hence, if a mom has COVID-19 during her pregnancy or even during birth, she does not need to worry that the virus will be present in the umbilical cord blood or the tissues of the placenta and umbilical cord. 

Virus protection from maternal antibodies 
 

Once again, the placenta is amazing: at the same time that it protects the baby from disease, it allows antibodies from the mother to cross into the baby’s blood. The baby inherits its mother’s immune system and has resistance to most diseases that mom resists until about age six months. 
If the mother has immunity to COVID-19, most likely so will the newborn baby. Any woman who has had the coronavirus and recovered from the illness is carrying protective antibodies. A small study in Wuhan China confirmed that, when 6 mothers who were sick with COVID-19 pneumonia gave birth, all of their babies had antibodies to COVID-19 in their blood
. Hopefully someday there will be a vaccine against COVID-19, and if mom has received the vaccine it should protect her newborn too. Studies have shown that seasonal influenza vaccines given to pregnant women have greatly reduced newborn flu infections, and the vaccine is effective when given at least two weeks before birth.

 Are cord blood banks screening moms for COVID-19? 
 

Yes, cord blood banks have modified their maternal health history forms to ask about possible exposure to COVID-19, even though the virus is not expected to appear in the umbilical cord blood or the tissues of the afterbirth. The philosophy is to collect the information now in case it becomes important later. 
Most public banks that collect cord blood donations have had to modify their procedures due to COVID-19, simply to reduce person-to-person contact. For example, maternal consent interviews might be conducted by telephone. If you are planning to donate your baby’s cord blood or placenta, check in advance to find out how the program at your delivery hospital is operating. 
Family cord blood banks have not had to change their collection procedures, because the cord blood is collected by the staff that will be in the delivery room anyway.

 How have cord blood banks modified their operations due to COVID-19? 
 

Cord blood banks are essential services that continue to operate during shelter in place orders. Ironically, COVID-19 has not required any changes to the laboratory operations of cord blood banks, but the banks have had to make accommodations to their logistics and personnel management. 
Once cord blood or birth tissue arrives in a laboratory for processing, it is managed with standard protections against blood borne pathogens. These include staff wearing personnel protective equipment and handling the blood and tissue samples under a hood that maintains a sterile field. Therefore, it is not necessary to take any additional precautions. 
However, the shipping of the collection kit to the laboratory can be fraught with difficulty during this pandemic, especially if the kit needs to travel long distance or cross international borders. Parents should talk to their bank to plan around this logistics. Most hospitals are restricting entry to only allow patients and staff, which means that medical couriers cannot pick up collection kits at the bedside. There have been reports that often someone close to the mother must walk the kit out of the hospital to the courier. 
 
When a collection kit containing cord blood or birth tissue arrives in a laboratory, it is placed in a special receiving zone, away from regular working areas in case the outside of the kit is contaminated with coronavirus. Designated personnel carefully open the kits and transfer the cord blood and tissue samples to the laboratory. 
The biggest concern that cord blood banks are struggling with at this time is the possibility that their staff will become sick with COVID-19. A worst case scenario would be a staff member infecting others at work. To guard against this, laboratory technicians have been assigned to teams that do not have contact with each other. Even if an entire team is exposed and has to be quarantined, the other teams can keep working. Common areas at the work place, such as locker rooms or break rooms, are cleaned repeatedly with medical grade disinfectant. Staff members either work remotely or stay socially distant. 

Is the coronavirus a reason to bank cord blood?
 During the COVID-19 pandemic, many parents are more mindful of ways that they can protect their baby’s health, and as a result we have seen a spike in inquiries about cord blood banking. Nonetheless, the long-term odds of using your child’s cord blood or birth tissues have not been changed by COVID-19. The basic motivation for banking cord blood is that it can benefit patients in need of donors or it can be a form of health insurance for your family.