Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Váncsa, Szilárd; Dembrovszky, Fanni; Farkas, Nelli; Szakó, Lajos; Teutsch, Brigitta; Bunduc, Ștefania; Nagy, Rita; Párniczky, Andrea; Erőss, Bálint; Péterfi, Zoltán; Hegyi, Péter

doi:10.3390/v13030512

Cited by 32 publications

(34 citation statements)

References 31 publications

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“…On the contrary, a higher requirement of ICU admission and mechanical ventilation was observed during reinfection in our review. A meta-analysis analysis of 123 cases by Vancsa et al[96] showed that the second episode of SARS-COV-2 infection is more severe than the first if it happens within 60 days of the first positive PCR. This deems the necessity of IPD analysis as many of the larger case series report more severe cases which might skew the overall findings.…”

Section: Discussionmentioning

confidence: 99%

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis of 577 cases

Dhillon

Qamar

Irfan

et al. 2021

Preprint

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Background As the COVID-19 pandemic rages on, reports on disparities in vaccine roll out alongside reinfection and reactivation from previously recovered cases have been emerging. With newer waves and variants of COVID-19, we conducted a systematic review to assess the determinants and disease spectrum of COVID-19 reinfection. Methods A comprehensive search covering relevant databases was conducted for observational studies reporting Polymerase Chain Reaction (PCR) confirmed infection and reinfection cases. Quality assessment tool developed by the National Institute of Health (NIH) for assessment of case series was used. Meta-analyses were performed using RevMan 5.3 for pooled proportions of findings in first infection and reinfection with 95% confidence interval (CI). Results Eighty-one studies reporting 577 cases were included from 22 countries. The mean age of patients was 46.2±18.9 years with males accounting for 45.8% of the study population while 179 (31.0%) cases of comorbidities were reported. The average time duration between first infection and reinfection was 63.6±48.9 days. During first infection and reinfection, fever was the most common symptom (41.4% and 36.4%,respectively) whilst anti-viral therapy was the most common treatment regimen administered (44.5% and 43.0%, respectively). Overall, comparable odds of symptomatic presentation and management were reported in the two infections. However, a higher Intensive Care Unit (ICU) admission rate was observed in reinfection compared to first infection (10 vs 3). Ten deaths were reported with 565 patients fully recovering. Respiratory failure was the most common cause of death (7/10 deaths). Seventy-two studies were determined to be of good quality whilst nine studies were of fair quality. Conclusion As the first global-scale systematic review of its kind, our findings support immunization practices given increased ICU admissions and mortality in reinfections. Our cohort serves as a guide for clinicians and authorities for devising an optimal strategy for controlling the pandemic.

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Section: Discussionmentioning

confidence: 99%

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis of 577 cases

Dhillon

Qamar

Irfan

et al. 2021

Preprint

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“…At least every patient received 4 COVID-19 PCR tests during his/her hospital stay. Concerning RT-PCR in urine and respiratory samples, viral RNA was extracted from 300 µL of urine and 300 µL of Naso-pharyngeal swab samples with an automated extraction instrument according to the manufacturer’s protocol (TanBead, Taiwan Advanced Nanotech Inc., Taiwan,) and previous scientific evidence (results as described previously) [ 12 ]. SARS-CoV-2 were detected by a real-time reverse transcription polymerase chain reaction (RT-PCR) assay using the Allplex™ SARS-CoV-2 Assay kit according to the manufacturer’s protocol (Seegene Inc., Seoul, Korea).…”

Section: Methodsmentioning

confidence: 99%

“…Indeed, while rRT-PCR by a nasopharyngeal swab is a well-defined method for the diagnosis of COVID-19, little data exist to assess the role of positive rRT-PCR in other biologic samples and its possible correlation with the disease severity and infectiousness to others [8][9][10]. In fact, disease severity is triggered by several predisposing factors, including viral shedding, that could be related to the immune response and infection control [11,12]. Indeed, COVID-19, as previously suggested, which shows systemic involvement [13], is also characterized by endothelium damage with an increase in fibrinogen serum levels [14] and is correlated to a worse prognosis [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 in Urine May Predict a Severe Evolution of COVID-19

Perrella

Brita

Coletta

et al. 2021

JCM

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We hypothesized that the spread of SARS-CoV-2 in urine during a severe COVID-19 infection may be the expression of the worsening disease evolution. Therefore, the aim of this study was to verify if the COVID-19 disease severity is related to the viral presence in urine samples. We evaluated the clinical evolution in acute COVID-19 patients admitted in the sub-intensive care and intensive care units between 28 of December 2020 and 15th of February 2021 and being positive for SARS-CoV-2 RNA in the respiratory tract, including repeated endotracheal aspirates (ETA), sputum, nasopharyngeal swabs (NPS) and urine. We found that those subjects with SARS-COV-2 in the urine at admittance (8 out of 60 eligible patients) had a more severe disease than those with negative SARS-CoV-2 in urine. Further, they showed an increase in fibrinogen and (C-reactive Protein) CRP serum levels, requiring mechanic ventilation. Of those with positive SARS-CoV-2 in the urine, 50% died. According to our preliminary results, it seems that the presence of SARS-CoV-2 in the urine characterizes patients with a more severe disease and is also related to a higher death rate.

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“…We found that the prevalence of reinfection after recovery from COVID-19 was very low and that prior infection with SARS-CoV-2 conferred an 80% protective efficacy against reinfection (assuming baseline prevalence of 5%). The existing reviews (23,(85)(86)(87)(88)(89)(90)(91)(92)(93)(94) have not examined the question of prevalent immunity sufficiently (Supplementary Table 4).…”

Section: Comparison Of Risk Of Sars-cov-2 Infection Between Individuals With and Those Without Prior Infectionmentioning

confidence: 99%

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

Chivese

Matizanadzo

Musa

et al. 2021

Preprint

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Objectives This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies as well as T and B memory cells during infection with SARS-CoV-2 and after recovery. In addition, prevalence of COVID-19 reinfection, and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. Methods and analyses A synthesis of existing research was conducted. The Cochrane Library for COVID-19 resources, the China Academic Journals Full Text Database, PubMed, and Scopus as well as preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. We included studies with the relevant outcomes of interest. All included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity between included studies was assessed using the I2 and Cochrans Q statistics and publication bias was assessed using Doi plots. Results Fifty-four studies, from 18 countries, with a total of 12 011 447 individuals, followed up to 8 months after recovery were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG 90.4% (95%CI 72.2 to 99.9, I2=89.0%, 5 studies), CD4+ 91.7% (95%CI 78.2 to 97.1, one study), and memory B cells 80.6% (95%CI 65.0 to 90.2, one study) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0 to 0.7, I2 = 98.8, 9 studies). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1 to 0.3, I2 = 90.5%, 5 studies). Conclusion Around 90% of people previously infected with SARS-CoV-2 had evidence of immunological memory to SARS-CoV-2, which was sustained for at least 6-8 months after recovery, and had a low risk of reinfection.

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Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Cited by 32 publications

References 31 publications

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis of 577 cases

The mystery of COVID-19 reinfections: A global systematic review and meta-analysis of 577 cases

SARS-CoV-2 in Urine May Predict a Severe Evolution of COVID-19

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery – a comprehensive systematic review and meta-analysis

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