Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers.

Autor: Adrielle Dos Santos L; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., Filho PGG; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., Silva AMF; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., Santos JVG; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., Santos DS; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., Aquino MM; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., de Jesus RM; Division of Pulmonology, Institute of Health Promotion and Assistance for Employees of the State of Sergipe (IPESAÚDE), Sergipe, Brazil., Almeida MLD; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., da Silva JS; Fiocruz - Bi-Institutional Translational Medicine Project, Ribeirao Preto Medical School, Department of Biochemistry and Immunology, 14049-900 Ribeirao Preto, SP, Brazil., Altmann DM; Department of Immunology and Inflammation, Faculty of Medicine, Imperial College, Hammersmith Hospital, London, W12 ONN, United Kingdom. Electronic address: d.altmann@ic.ac.uk., Boyton RJ; Department of Immunology and Inflammation, Faculty of Medicine, Imperial College, Hammersmith Hospital, London, W12 ONN, United Kingdom., Alves Dos Santos C; Health Foundation Parreiras Horta, Central Laboratory of Public Health (LACEN/SE), State Secretary for Health, Sergipe, Brazil., Santos CNO; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil., Alves JC; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil., Santos IL; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil., Magalhães LS; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil., Belitardo EMMA; Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., Rocha DJPG; Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., Almeida JPP; Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte-MG, Brazil., Pacheco LGC; Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., Aguiar ERGR; Department of Biological Sciences, Center of Biotechnology and Genetics, State University of Santa Cruz (UESC), Ilhéus-BA, Brazil., Campos GS; Virology Laboratory, Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., Sardi SI; Virology Laboratory, Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., Carvalho RH; Virology Laboratory, Institute of Health Sciences, Federal University of Bahia, Salvador-BA, Brazil., de Jesus AR; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil., Rezende KF; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil., de Almeida RP; Department of Medicine, Federal University of Sergipe, Immunology Investigative Institute (III), INCT, CNPq, Aracaju, Sergipe 49060-100, Brazil; Division of Immunology and Molecular Biology Laboratory, University Hospital/EBSERH, Federal University of Sergipe, Sergipe CEP 49.060-025, Brazil. Electronic address: roquepachecoalmeida@gmail.com.
Jazyk: angličtina
Zdroj: The Journal of infection [J Infect] 2021 Mar; Vol. 82 (3), pp. 399-406. Date of Electronic Publication: 2021 Feb 13.
DOI: 10.1016/j.jinf.2021.01.020
Abstrakt: Background: There is growing concern about individuals reported to suffer repeat COVID-19 disease episodes, these in a small number of cases characterised as de novo infections with distinct sequences, indicative of insufficient protective immunity even in the short term.
Methods: Observational case series and case-control studies reporting 33 cases of recurrent, symptomatic, qRT-PCR positive COVID-19. Recurrent disease was defined as symptomatic recurrence after symptom-free clinical recovery, with release from isolation >14 days from the beginning of symptoms confirmed by qRT-PCR. The case control study-design compared this group of patients with a control group of 62 patients randomly selected from the same COVID-19 database.
Results: Of 33 recurrent COVID-19 patients, 26 were female and 30 were HCW. Mean time to recurrence was 50.5 days which was associated with being a HCW (OR 36.4 (p <0.0001)), and blood type A (OR 4.8 (p = 0.002)). SARS-CoV-2 antibodies were signifcantly lower in recurrent patients after initial COVID-19  (2.4 ± 0.610; p<0.0001) and after recurrence (6.4 ± 11.34; p = 0.007).  Virus genome sequencing identified reinfection by a different isolate in one patient.
Conclusions: This is the first detailed case series showing COVID-19 recurrence with qRT-PCR positivity. For one individual detection of phylogenetically distinct genomic sequences in the first and second episodes confirmed bona fide renfection, but in most cases the data do not formally distinguish between reinfection and re-emergence of a chronic infection reservoir. These episodes were significantly associated with reduced Ab response during initial disease and argue the need for ongoing vigilance without an assumption of protection after a first episode.
Competing Interests: Declaration of Competing Interests All authors report there are no conflicts of interest.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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