Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection Without Mutations in the Spike Protein

Kulkarni, Onkar; Narreddy, Suneetha; Zaveri, Lamuk; Kalal, Irawathy Goud; Tallapaka, Karthik Bharadwaj; Sowpati, Divya Tej

doi:10.1093/cid/ciab136

Cited by 10 publications

(8 citation statements)

References 6 publications

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“…In total, 35 articles describing the clinical courses of 60 unique individuals were identified that met the criteria. 7 – 14 , 18 – 43 An additional 114 articles were identified following abstract screening, but were not included in the analysis because they did not have sufficient sequencing results to conclude that the cases were reinfections. In total, 60 cases of verified reinfection were identified in this search.…”

Section: Resultsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Massachi

Donohue

Kelly

2021

The American Journal of Tropical Medicine and Hygiene

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Evaluating the reinfection may offer some insight into areas for further investigation regarding durability of immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sixty cases of reinfection with viral sequencing were identified in PubMed, Embase, Web of Science, and medRxiv before May 1, 2021.Episodes of infection were separated by a median of 116 days. Severity of illness was greater among individuals reinfected within 90 days of initial infection, no asymptomatic initial cases developed severe reinfection, nearly half of cases had suspected escape variants, and nearly all individual tested following reinfection were found to have detectable levels of anti-SARS-CoV-2 antibodies. This analysis is limited by the heterogeneous methods used among reports. Reinfection continues to be relatively rare. As the case rate presumably increases over time, this review will inform measurements to determine the natural history and causal determinants of reinfection in more rigorous observational cohort studies and other standardized surveillance approaches.

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Section: Resultsmentioning

confidence: 99%

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Massachi

Donohue

Kelly

2021

The American Journal of Tropical Medicine and Hygiene

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“…In the 36 studies (n = 51) [8-10, 32-37, 39, 43-45, 47-54, 56, 57, 59-62, 64-69, 71-73], which reported details of patients' symptoms during the first infection, these commonly included cough (30, 62.3%), fever (31, 58.5%), headache (20, 37.7%), diarrhea (13, 24.5%), sore throat (12, 22.6%), myalgia (12,22.6%), dyspnea (11,20.8%), rhinitis (9, 17%), fatigue (7, 13.2%), chills (6, 11.3%), anosmia (5, 9.4%), ageusia (5, 9.4%), malaise (4, 7.5%), chest pain (4, 7.5%), nasal congestion (4, 7.5%), odynophagia (4, 7.5%), nausea (3 5.7%), vomiting (2, 3.8%), anxiety (2, 3.8%), lethargy (2, 3.8%), panic attacks (1, 1.9%), sneezing (1, 1.9%), confusion (1, 1.9%), body pain (1, 1.9%), arthralgia (1, 1.9%), exertional tachycardia (1, 1.9%), dizziness (1, 1.9%), and arthromyalgia (1, 1.9%), and 10 (18.9%) patients [31,33,36,41,46,48,55,70] were asymptomatic.…”

Section: Symptoms Of Reinfected Patientsmentioning

confidence: 99%

Reinfection in patients with COVID-19: a systematic review

Ren

Zhou

Guo

et al. 2022

glob health res policy

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Background With the continuation of the COVID-19 pandemic, some COVID-19 patients have become reinfected with the virus. Viral gene sequencing has found that some of these patients were reinfected by the different and others by same strains. This has raised concerns about the effectiveness of immunity after infection and the reliability of vaccines. To this end, we conducted a systematic review to assess the characteristics of patients with reinfection and possible causes. Methods A systematic search was conducted across eight databases: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and SinoMed from December 1, 2019 to September 1, 2021. The quality of included studies were assessed using JBI critical appraisal tools and Newcastle–Ottawa Scale. Results This study included 50 studies from 20 countries. There were 118 cases of reinfection. Twenty-five patients were reported to have at least one complication. The shortest duration between the first infection and reinfection was 19 days and the longest was 293 days. During the first infection and reinfection, cough (51.6% and 43.9%) and fever (50% and 30.3%) were the most common symptoms respectively. Nine patients recovered, seven patients died, and five patients were hospitalized, but 97 patients’ prognosis were unknown. B.1 is the most common variant strain at the first infection. B.1.1.7, B.1.128 and B.1.351 were the most common variant strains at reinfection. Thirty-three patients were infected by different strains and 9 patients were reported as being infected with the same strain. Conclusions Our research shows that it is possible for rehabilitated patients to be reinfected by SARS-COV-2. To date, the causes and risk factors of COVID-19 reinfection are not fully understood. For patients with reinfection, the diagnosis and management should be consistent with the treatment of the first infection. The public, including rehabilitated patients, should be fully vaccinated, wear masks in public places, and pay attention to maintaining social distance to avoid reinfection with the virus.

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“…Noteworthy, some cases of confirmed reinfection did not present any mutation in the Spike protein. Moreover, most of these cases without mutations in the Spike did have a positive result in the serology test after the first episode as previously reported ( Choudhary et al, 2021 ; Kulkarni et al, 2021 ), suggesting that these patients did not have an effective antibody response against a virus with similar antigenic properties to Wuhan strain.…”

Section: Discussionmentioning

confidence: 50%

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

et al. 2022

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BackgroundSince the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the main concern is whether reinfections are possible, and which are the associated risk factors. This study aims to describe the clinical and molecular characteristics of 24 sequence-confirmed reinfection SARS-CoV-2 cases over 1 year in Barcelona (Catalonia, Spain).MethodsPatients with > 45 days between two positive PCR tests regardless of symptoms and negative tests between episodes were initially considered as suspected reinfection cases from November 2020 to May 2021. Whole-genome sequencing (WGS) was performed to confirm genetic differences between consensus sequences and for phylogenetic studies based on PANGOLIN nomenclature. Reinfections were confirmed by the number of mutations, change in lineage, or epidemiological criteria.ResultsFrom 39 reported suspected reinfection cases, complete viral genomes could be sequenced from both episodes of 24 patients, all were confirmed as true reinfections. With a median age of 44 years (interquartile range [IQR] 32–65), 66% were women and 58% were healthcare workers (HCWs). The median days between episodes were 122 (IQR 72–199), occurring one-third within 3 months. Reinfection episodes were frequently asymptomatic and less severe than primary infections. The absence of seroconversion was associated with symptomatic reinfections. Only one case was reinfected with a variant of concern (VOC).ConclusionSevere acute respiratory syndrome coronavirus 2 reinfections can occur in a shorter time than previously reported and are mainly found in immunocompetent patients. Surveillance through WGS is useful to identify viral mutations associated with immune evasion.

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Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection Without Mutations in the Spike Protein

Cited by 10 publications

References 6 publications

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Reinfection in patients with COVID-19: a systematic review

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

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