Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Patients Undergoing Serial Laboratory Testing

Qureshi, Adnan I; Baskett, William I; Huang, Wei; Lobanova, Iryna; Naqvi, S. Hasan; Shyu, Chi‐Ren

doi:10.1093/cid/ciab345

Cited by 64 publications

(69 citation statements)

References 43 publications

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“…Several studies have documented SARS-CoV-2 reinfections, but reassuringly so far, the risk of reinfection appears to be low (16)(17)(18). While most reinfections are thought to be mild (19), a study in India documented reinfections in healthcare workers (20), where the second episode was more severe than the first. Some evidence suggests that those with asymptomatic or mild infections may have less robust and durable protection against future infection (21).…”

Section: Positionmentioning

confidence: 99%

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

Shastri

Parikh

Aggarwal³

et al. 2021

Front. Med.

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Background: Post infection immunity and post vaccination immunity both confer protection against COVID-19. However, there have been many whole genome sequencing proven reinfections and breakthrough infections. Both are most often mild and caused by Variants of Concern (VOC).Methods: The patient in our study underwent serial COVID-19 RT-PCR, blood tests for serology, acute phase reactants, and chest imaging as part of clinical care. We interviewed the patient for clinical history and retrieved reports and case papers. We retrieved stored RT-PCR positive samples for whole genome sequencing (WGS) of SARS-CoV-2 from the patient's breakthrough infections and the presumed index case.Findings: The patient had three RT-PCR confirmed SARS-CoV-2 infections. Two breakthrough infections occurred in quick succession with the first over 3 weeks after complete vaccination with COVISHIELD and despite post-vaccination seroconversion. The first breakthrough infection was due to the Alpha variant and the second due to the Delta variant. The Delta variant infection resulted in hypoxia, hospitalization, and illness lasting seven weeks. Serial serology, acute phase reactants, and chest imaging supported WGS in establishing distinct episodes of infection. WGS established a fully vaccinated family member as the index case.Interpretation: The patient had an Alpha variant breakthrough infection despite past infection, complete vaccination, and seroconversion. Despite boosting after this infection, the patient subsequently had a severe Delta variant breakthrough infection. This was also a WGS proven reinfection and, therefore, a case of breakthrough reinfection. The patient acquired the infection from a fully vaccinated family member.

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Section: Positionmentioning

confidence: 99%

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

Shastri

Parikh

Aggarwal³

et al. 2021

Front. Med.

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“…Furthermore, investigators have reported that even those with prior SARS-CoV-2 infection who lacked detectable antibodies were at 80% lower risk of reinfection than people who were SARS-CoV-2 naı ¨ve (Breathnach et al, 2021). One retrospective study that analyzed test results among nearly 10,000 individuals with prior SARS-CoV-2 infection found that only 0.7% became reinfected with SARS-CoV-2 (Qureshi et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of the Protective Effect of Prior SARS-CoV-2 Infection on Repeat Infection

2021

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We systematically reviewed studies to estimate the risk of SARS-CoV-2 reinfection among those previously infected with SARS-CoV-2. For this systematic review, we searched scientific publications on PubMed and MedRxiv, a pre-print server, through August 18, 2021. Eligible studies were retrieved on August 18, 2021. The following search term was used on PubMed: (((“Cohort Studies”[Majr]) AND (“COVID-19”[Mesh] OR “SARS-CoV-2”[Mesh])) OR “Reinfection”[Majr]) OR “Reinfection”[Mesh]. The following search term was used on MedRxiv: “Cohort Studies” AND “COVID-19” OR “SARS-CoV-2” AND “Reinfection”. The search terms were broad to encompass all applicable studies. There were no restrictions on the date of publication. Studies that did not describe cohorts with estimates of the risk of SARS-CoV-2 reinfection among those with previous infection were excluded. Studies that included vaccinated participants were either excluded or limited to sub-groups of non-vaccinated individuals. To identify relevant studies with appropriate control groups, we developed the following criteria for studies to be included in the systematic analysis: (1) baseline polymerase chain reaction (PCR) testing, (2) a uninfected comparison group, (3) longitudinal follow-up, (4) a cohort of human participants, i.e. not a case report or case series, and (5) outcome determined by PCR. The review was conducted following PRISMA guidelines. We assessed for selection, information, and analysis bias, per PRISMA guidelines. We identified 1,392 reports. Of those, 10 studies were eligible for our systematic review. The weighted average risk reduction against reinfection was 90.4% with a standard deviation of 7.7% ( p-value: <0.01). Protection against SARS-CoV-2 reinfection was observed for up to 10 months. Studies had potential information, selection, and analysis biases. The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination. More research is needed to characterize the duration of protection and the impact of different SARS-CoV-2 variants.

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“…While waning antibody titers suggest that re-infection is possible over time, we do not believe that our assumptions about re-infection meaningfully impact our results. 16,17 In addition, we used data that have been aggregated from state-level reporting mechanisms, which are vulnerable to a number of potential sources of bias. States vary in their reporting criteria (e.g.…”

Section: Discussionmentioning

confidence: 99%

Reconstructing the course of the COVID-19 epidemic over 2020 for US states and counties: results of a Bayesian evidence synthesis model

Chitwood

Russi

Gunasekera

et al. 2020

Preprint

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Real-time estimates of the true size and trajectory of local COVID-19 epidemics are key metrics to guide policy responses. We developed a Bayesian nowcasting approach that explicitly accounts for reporting delays and secular changes in case ascertainment to generate real-time estimates of COVID-19 epidemiology on the basis of reported cases and deaths. Using this approach, we estimate time trends in infections, symptomatic cases, and deaths for all 50 US states and the District of Columbia from early-March through June 11, 2020. At the beginning of June, our best estimates of the effective reproduction number (Rt) are close to 1 in most states, indicating a stabilization of incidence, but there is considerable variability in the level of incidence and the estimated proportion of the population that has already been infected.

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Reinfection With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Patients Undergoing Serial Laboratory Testing

Cited by 64 publications

References 43 publications

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

Severe SARS-CoV-2 Breakthrough Reinfection With Delta Variant After Recovery From Breakthrough Infection by Alpha Variant in a Fully Vaccinated Health Worker

A Systematic Review of the Protective Effect of Prior SARS-CoV-2 Infection on Repeat Infection

Reconstructing the course of the COVID-19 epidemic over 2020 for US states and counties: results of a Bayesian evidence synthesis model

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