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Allahverdiyeva A, Ağaçfidan A, Dogan L, Önel M, Uysal HK, Medetalibeyoğlu A, Şenkal N, Alaskarov E, Meşe S. Evaluation of SARS-CoV-2-Positive Patients with Suspected Reinfection. Viruses 2023; 15:2222. [PMID: 38005899 PMCID: PMC10675471 DOI: 10.3390/v15112222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this study was to investigate the reinfection rates and characteristics of SARS-CoV-2 in individuals with SARS-CoV-2 RNA present in their clinical specimens for COVID-19. Our data from the COVID-19 Laboratory of Istanbul University were analyzed for 27,240 cases between 27 March 2020 to 8 February 2022. Demographic characteristics, vaccination statuses, comorbidities, and laboratory findings were evaluated in cases with suspected reinfection, as determined by the presence of SARS-CoV-2 RNA at a rate of 0.3% in clinical specimens. When comparing laboratory values, leukocyte counts were lower in the second and third infections compared with the first infection (p = 0.035), and neutrophil counts were lower in the second infection (p = 0.009). Symptoms varied, with coughing being common in the first infection and malaise being common in subsequent infections. These results suggest that it is important to continue to monitor reinfection rates and develop strategies to prevent reinfection. Our results also suggest that clinicians should be aware of the possibility of reinfection and monitor patients for recurrent symptoms.
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Affiliation(s)
- Aytaj Allahverdiyeva
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
- Department of Medical Microbiology, Azerbaijan Medical University, Baku 370022, Azerbaijan
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Lerzan Dogan
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
| | - Mustafa Önel
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Hayriye Kırkoyun Uysal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Alpay Medetalibeyoğlu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Naci Şenkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Elvin Alaskarov
- Department of Otorhinolaryngology, Istanbul Medipol University, Istanbul 34230, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
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Balde T, Oyugi B, Karamagi H, Okeibunor JC, Conteh IN, Ejiofor NE, Atuhebwe P, Nanyunja M, Diallo AB, Mihigo R, Yoti Z, Braka F, Gueye AS. Framing the future of the COVID-19 response operations in 2022 in the WHO African region. Glob Health Action 2022; 15:2130528. [PMID: 36314610 PMCID: PMC9629107 DOI: 10.1080/16549716.2022.2130528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND With the evolving epidemiological parameters of COVID-19 in Africa, the response actions and lessons learnt during the pandemic's past two years, SARS-COV 2 will certainly continue to circulate in African countries in 2022 and beyond. As countries in the African continent need to be more prepared and plan to 'live with the virus' for the upcoming two years and after and at the same time mitigate risks by protecting the future most vulnerable and those responsible for maintaining essential services, WHO AFRO is anticipating four interim scenarios of the evolution of the pandemic in 2022 and beyond in the region. OBJECTIVE In preparation for the rollout of response actions given the predicted scenarios, WHO AFRO has identified ten strategic orientations and areas of focus for supporting member states and partners in responding to the COVID-19 pandemic in Africa in 2022 and beyond. METHODS WHO analysed trends of the transmissions since the first case in the African continent and reviewed lessons learnt over the past months. RESULTS Establishing a core and agile team solely dedicated to the COVID-19 response at the WHO AFRO, the emergency hubs, and WCOs will improve the effectiveness of the response and address identified challenges. The team will collaborate with the various clusters of the regional office, and other units and subunits in the WCOs supported with good epidemics intelligence. COVID-19 pandemic has afflicted global humanity at unprecedented levels. CONCLUSION Two years later and while starting the third year of the COVID-19 response, we now need to change and adapt our strategies, tools and approaches in responding timely and effectively to the pandemic in Africa and save more lives.
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Affiliation(s)
- Thierno Balde
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Boniface Oyugi
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo,Centre for Health Services Studies (CHSS), University of Kent, George Allen Wing, CanterburyUK
| | - Humphrey Karamagi
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Joseph Chukwudi Okeibunor
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo,CONTACT Joseph Chukwudi Okeibunor World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Ishata Nannie Conteh
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Nonso Ephraim Ejiofor
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Phionah Atuhebwe
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Miriam Nanyunja
- Emergency Preparedness and Response Hub, World Health Organisation Emergency Hub for East and Southern Africa, Nairobi, Kenya
| | - Amadou Bailo Diallo
- Emergency Preparedness and Response Hub, World Health Organisation Emergency Hub for East and Southern Africa, Nairobi, Kenya,World Health Organisation Emergency Hub for West and Central Africa, Dakar, Senegal
| | - Richard Mihigo
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Zabulon Yoti
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Fiona Braka
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
| | - Abdou Salam Gueye
- World Health Organisation, Regional Office for Africa, Emergency Preparedness and Response Programme, Brazzaville, Congo
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Strasser ZH, Greifer N, Hadavand A, Murphy SN, Estiri H. Estimates of SARS-CoV-2 Omicron BA.2 Subvariant Severity in New England. JAMA Netw Open 2022; 5:e2238354. [PMID: 36282501 PMCID: PMC9597387 DOI: 10.1001/jamanetworkopen.2022.38354] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE The SARS-CoV-2 Omicron subvariant, BA.2, may be less severe than previous variants; however, confounding factors make interpreting the intrinsic severity challenging. OBJECTIVE To compare the adjusted risks of mortality, hospitalization, intensive care unit admission, and invasive ventilation between the BA.2 subvariant and the Omicron and Delta variants, after accounting for multiple confounders. DESIGN, SETTING, AND PARTICIPANTS This was a retrospective cohort study that applied an entropy balancing approach. Patients in a multicenter inpatient and outpatient system in New England with COVID-19 between March 3, 2020, and June 20, 2022, were identified. EXPOSURES Cases were assigned as being exposed to the Delta (B.1.617.2) variant, the Omicron (B.1.1.529) variant, or the Omicron BA.2 lineage subvariants. MAIN OUTCOMES AND MEASURES The primary study outcome planned before analysis was risk of 30-day mortality. Secondary outcomes included the risks of hospitalization, invasive ventilation, and intensive care unit admissions. RESULTS Of 102 315 confirmed COVID-19 cases (mean [SD] age, 44.2 [21.6] years; 63 482 women [62.0%]), 20 770 were labeled as Delta variants, 52 605 were labeled as the Omicron B.1.1.529 variant, and 28 940 were labeled as Omicron BA.2 subvariants. Patient cases were excluded if they occurred outside the prespecified temporal windows associated with the variants or had minimal longitudinal data in the Mass General Brigham system before COVID-19. Mortality rates were 0.7% for Delta (B.1.617.2), 0.4% for Omicron (B.1.1.529), and 0.3% for Omicron (BA.2). The adjusted odds ratio of mortality from the Delta variant compared with the Omicron BA.2 subvariants was 2.07 (95% CI, 1.04-4.10) and that of the original Omicron variant compared with the Omicron BA.2 subvariant was 2.20 (95% CI, 1.56-3.11). For all outcomes, the Omicron BA.2 subvariants were significantly less severe than that of the Omicron and Delta variants. CONCLUSIONS AND RELEVANCE In this cohort study, after having accounted for a variety of confounding factors associated with SARS-CoV-2 outcomes, the Omicron BA.2 subvariant was found to be intrinsically less severe than both the Delta and Omicron variants. With respect to these variants, the severity profile of SARS-CoV-2 appears to be diminishing after taking into account various factors including therapeutics, vaccinations, and prior infections.
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Affiliation(s)
- Zachary H. Strasser
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Noah Greifer
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
| | - Aboozar Hadavand
- College of Computational Science, Minerva University, San Francisco, California
| | - Shawn N. Murphy
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Hossein Estiri
- MGH Laboratory of Computer Science, Massachusetts General Hospital, Boston
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Toro-Huamanchumo C, Hilario-Gomez M, Pinedo-Castillo L, Zumarán-Nuñez C, Espinoza-Gonzales F, Caballero-Alvarado J, Rodriguez-Morales A, Barboza J. Clinical and epidemiological features of patients with COVID-19 reinfection: a systematic review. New Microbes New Infect 2022; 48:101021. [PMID: 36060548 PMCID: PMC9420201 DOI: 10.1016/j.nmni.2022.101021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/29/2022] [Accepted: 08/19/2022] [Indexed: 11/24/2022] Open
Abstract
Recurrent positivity in a patient with COVID-19 may be due to various reasons, not necessarily reinfection. There is concern about the occurrence frequency of reinfection. Five databases and a preprint/preprint repository were searched. All case reports, case series, and observational studies were included. Bias was assessed for each study with the Newcastle-Ottawa Scale tool and reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA-2020). After eligibility, 77 studies were included for qualitative synthesis (52 case reports, 21 case series, and four case-controls; 1131 patients included). Of these, 16 studies described a second contact with the SARS-CoV-2 positive case, five studies described healthcare profession-related infection, ten studies described that the source of reinfection was likely to be from the community, one study described travel-related infection, nine studies described vulnerability-related infection due to comorbidity. The mean number of days from discharge or negative test to reinfection ranged from 23.3 to 57.6 days across the different included studies. The risk of bias for all case report/series studies was moderate/high. For observational studies, the risk of bias was low. Reinfection of patients with COVID-19 occurs between the first and second month after the first infection, but beyond, and 90 days have been proposed as a point to begin to consider it. The main factor for reinfection is contact with COVID-19 positive cases.
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Affiliation(s)
| | - M.M. Hilario-Gomez
- Sociedad científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - L. Pinedo-Castillo
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - C.J. Zumarán-Nuñez
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - F. Espinoza-Gonzales
- Asociación Científica de Estudiantes de Medicina de la Universidad Señor de Sipán, Escuela Profesional de Medicina Humana de la Universidad Señor de Sipán, Chiclayo, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - J. Caballero-Alvarado
- Escuela de Medicina, Universidad Privada Antenor Orrego, Peru
- Universidad Señor de Sipán, Chiclayo, Peru
| | - A.J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
- Universidad Cientifica del Sur, Lima, Peru
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Shalaby A, Laharwani H, Bates JT, Kyle PB. Efficacy of POC Antibody Assays after COVID-19 Infection and Potential Utility for "Immunity Passports". Lab Med 2022; 53:262-265. [PMID: 34791323 PMCID: PMC8690030 DOI: 10.1093/labmed/lmab093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Numerous manufacturers market lateral flow assays for the detection of SARS-CoV-2 antibodies, but there are many questions about the reliability and efficacy of these tests. MATERIALS AND METHODS Serum specimens from 60 individuals were analyzed using 2 lateral flow antibody assays, an in-house enzyme-linked immunosorbent assay (ELISA), and the Abbott SARS-CoV-2 IgG chemiluminescent immunoassay. RESULTS The BioMedomics and Premier Biotech lateral flow assays were positive for IgM in 73.3% and 70% and for IgG in 80% and 73.3% of specimens, respectively. The ELISA assay was positive for IgM and IgG in 73.3% and 86.7% of specimens from infected individuals, whereas the Abbott assay was positive in 80%. The specificities of the 4 assays ranged from 96.7% to 100% for IgM and from 93.3% to 100% for IgG. CONCLUSION Results of the 2 lateral flow assays were comparable to those of the ELISA and Abbott assays. Assay efficacy depended on length of time after SARS-CoV-2 infection.
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Affiliation(s)
- Akram Shalaby
- University of Mississippi Medical Center, Jackson, Mississippi, US
| | | | - John T Bates
- University of Mississippi Medical Center, Jackson, Mississippi, US
| | - Patrick B Kyle
- University of Mississippi Medical Center, Jackson, Mississippi, US
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Second infection with SARS-CoV-2 wild-type is associated with increased disease burden after primary SARS-CoV-2/HBoV-1 coinfection, Cologne, Germany. Access Microbiol 2022. [DOI: 10.1099/acmi.0.000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
SARS-CoV-2 is the cause of the still-ongoing COVID-19 pandemic. To date reports on re-infections after full recovery from a previous COVID-19 course remain limited due to the fact that re-infections or second infections occur at the earliest between 3 to 24 months after full recovery while the pandemic lasts only since a year. Even less data are available on re-infections associated with emerging variants.
A 33-year-old previously healthy male patient was tested twice SARS-CoV-2 RNA positive with an 8 months symptom-free interval between the two COVID-19 episodes in our setting in Cologne, Germany. While the first episode was accompanied by a co-detection of human bocavirus and hardly any symptoms, the second episode was characterized by serious illness and severe flu-like symptoms, although hospitalization was not required. After the first episode no residual viral RNA was detected after the patient was released from quarantine. Follow up of the patient revealed a moderate but significant reduction of the lung volume and slightly impaired diffusion capacity.
Conclusion. While it is known that re-infections with SARS-CoV-2 may occur this is the first report of a co-detection of human bocavirus (HBoV) during a primary SARS-CoV-2 infection. The first, hardly symptomatic episode showed that co-infections do not necessarily initiate severe COVID-19 courses. The second more severe episode with serious flu-like symptoms could be explained by the sustained mild damage of the airways during the primary infection.
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Ebrahimi V, Sharifi M, Mousavi-Roknabadi RS, Sadegh R, Khademian MH, Moghadami M, Dehbozorgi A. Predictive determinants of overall survival among re-infected COVID-19 patients using the elastic-net regularized Cox proportional hazards model: a machine-learning algorithm. BMC Public Health 2022; 22:10. [PMID: 34986818 PMCID: PMC8727465 DOI: 10.1186/s12889-021-12383-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Narrowing a large set of features to a smaller one can improve our understanding of the main risk factors for in-hospital mortality in patients with COVID-19. This study aimed to derive a parsimonious model for predicting overall survival (OS) among re-infected COVID-19 patients using machine-learning algorithms. METHODS The retrospective data of 283 re-infected COVID-19 patients admitted to twenty-six medical centers (affiliated with Shiraz University of Medical Sciences) from 10 June to 26 December 2020 were reviewed and analyzed. An elastic-net regularized Cox proportional hazards (PH) regression and model approximation via backward elimination were utilized to optimize a predictive model of time to in-hospital death. The model was further reduced to its core features to maximize simplicity and generalizability. RESULTS The empirical in-hospital mortality rate among the re-infected COVID-19 patients was 9.5%. In addition, the mortality rate among the intubated patients was 83.5%. Using the Kaplan-Meier approach, the OS (95% CI) rates for days 7, 14, and 21 were 87.5% (81.6-91.6%), 78.3% (65.0-87.0%), and 52.2% (20.3-76.7%), respectively. The elastic-net Cox PH regression retained 8 out of 35 candidate features of death. Transfer by Emergency Medical Services (EMS) (HR=3.90, 95% CI: 1.63-9.48), SpO2≤85% (HR=8.10, 95% CI: 2.97-22.00), increased serum creatinine (HR=1.85, 95% CI: 1.48-2.30), and increased white blood cells (WBC) count (HR=1.10, 95% CI: 1.03-1.15) were associated with higher in-hospital mortality rates in the re-infected COVID-19 patients. CONCLUSION The results of the machine-learning analysis demonstrated that transfer by EMS, profound hypoxemia (SpO2≤85%), increased serum creatinine (more than 1.6 mg/dL), and increased WBC count (more than 8.5 (×109 cells/L)) reduced the OS of the re-infected COVID-19 patients. We recommend that future machine-learning studies should further investigate these relationships and the associated factors in these patients for a better prediction of OS.
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Affiliation(s)
- Vahid Ebrahimi
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Sharifi
- Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Emergency Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razieh Sadat Mousavi-Roknabadi
- Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Emergency Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Robab Sadegh
- Emergency Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Khademian
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Moghadami
- Noncommunicable Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afsaneh Dehbozorgi
- Emergency Medicine Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Rieke GJ, Monin MB, Breitschwerdt S, Boesecke C, Schlabe S. Confirmed SARS-CoV-2 Reinfection After 1 Year in a Patient with X-linked Agammaglobulinaemia. Infect Dis (Lond) 2022. [DOI: 10.17925/id.2022.1.1.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Though a comprehensive analysis of the immunity following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been performed, little is known about the duration of this protection and the risk of reinfection. This lack of knowledge is of particular interest for patients with impaired immune function. In this report, we describe the course of infection of a 30-year-old male patient with X-linked agammaglobulinaemia, who was reinfected with SARS-CoV-2 after a primary infection 12 months earlier. The initial course of infection took place in April 2020 with the typical symptoms of an upper respiratory tract infection accompanied by compatible changes in laboratory values and computed tomography. With no anti-viral treatment options at that time of the pandemic, only symptomatic therapy could be offered. Twelve months later (April 2021), the patient presented with a short course of fever and headache. Laboratory testing showed elevated C-reactive protein levels, while leukocytes, lymphocytes and lactate dehydrogenase levels were within range. The patient was admitted, and antibiotic treatment was started partially because procalcitonin levels were slightly elevated as well. The SARS-CoV-2 polymerase chain reaction was positive, and therapy with the monoclonal SARS-CoV-2 antibodies casirivimab/imdevimab (1,200 mg/1,200 mg, respectively) were initiated. The course of infection was mild, but low-flow oxygen had to be administered. It was not possible to distinguish between the contribution of the administered antibodies and the role of cytotoxic T-cells in the course of infection. Variant screenings confirmed the Wuhan strain of the virus for the first episode and the alpha variant for the second episode, thus confirming reinfection and ruling out long-term shedding. Neutralizing antibodies seem to play a crucial role in viral clearance and infection prevention, assuming patients with agammaglobulinaemia are at higher risk for a severe course of coronavirus disease 2019. Still, the specific role of neutralizing antibodies and cytotoxic T-cells is not fully understood. Reinfection among this patient population has only been described occasionally. Our case described a reinfection, which was confirmed by variant-testing. In addition, it gave insight into the rapid progression of testing and into specific anti-viral therapy over 1 year of the pandemic.
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Farrukh L, Mumtaz A, Sana MK. How strong is the evidence that it is possible to get SARS-CoV-2 twice? A systematic review. Rev Med Virol 2021; 31:1-12. [PMID: 34546605 PMCID: PMC7883277 DOI: 10.1002/rmv.2203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023]
Abstract
With a large number of coronavirus disease 2019 (Covid-19) patients being discharged from hospital with negative test results for SARS-CoV-2, it has been reported that several recovered cases tested positive after discharge (re-positive, RP). This finding has raised several important questions for this novel coronavirus and Covid-19 disease. In this review, we have discussed several important questions, including: (1) Can the virus re-infect recovered individuals? (2) What are the possible causes of the re-positive reverse transcriptase-polymerase chain reaction (RT-PCR) test in recovered patients? (3) What are the implications of these re-positive cases concerning the spread of the virus? Understanding how recovery from Covid-19 confers immunity to decrease the risk of re-infection is needed to inform current efforts to safely scale back population-based interventions, such as physical distancing. We have also described what is currently known about the immune response to Covid-19, highlighted key gaps in knowledge, and identified opportunities for future research. Overall, the quality of the evidence is poor and we describe the features that should be described for future cases.
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Affiliation(s)
| | - Aqsa Mumtaz
- King Edward Medical UniversityLahorePakistan
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10
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Ozbalci D. A tale of two diseases: Sarcoidosis, COVID-19 and new therapeutic options with dual RAS inhibition and tetanus-diphtheria vaccine. Med Hypotheses 2021; 152:110619. [PMID: 34102600 PMCID: PMC8168307 DOI: 10.1016/j.mehy.2021.110619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/25/2021] [Accepted: 05/30/2021] [Indexed: 01/08/2023]
Abstract
Sars Cov-2, the pathogen which belongs to the beta coronavirus family that is responsible for COVID-19, uses Angiotensin Converting Enzyme 2 (ACE2) as a receptor, which is responsible for controlling the actions of renin-angiotensin system (RAS). Sars Cov-2 - ACE2 binding leads to a RAS mediated immune response, which targets especially lungs to form ARDS, which in turn, is the most important cause of mortality in COVID-19. CD8+ T cell response dominates over CD4+ T cell response and natural killer cell dysfunction also leads to CD4+ cell dysfunction in COVID-19; this immune dysregulation leads to inappropriate (ARDS) and inadequate (low or quickly waning antibodies) responses to the disease and unfortunately, prepares the patients for re-infections. The peripheral anergy seen in chronic sarcoidosis has much resemblance to COVID-19; CD8+ T cell accumulation is also responsible for inadequate reaction to tuberculin and antigenic stimulus. This article, based on the similarity of COVID-19 and sarcoidosis, discusses a combination of the therapeutic strategy of the tetanus-diphtheria vaccine and dual RAS inhibition, alongside with hydroxychloroquine and antiviral agents, as a solution to overcome the problems described above.
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Affiliation(s)
- Demircan Ozbalci
- Suleyman Demirel University School of Medicine, Department of Hematology, Dogu Yerleskesi Cunur, Isparta, Turkey.
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11
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Tang X, Musa SS, Zhao S, He D. Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review. Front Public Health 2021; 9:663045. [PMID: 34178920 PMCID: PMC8226004 DOI: 10.3389/fpubh.2021.663045] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/26/2021] [Indexed: 12/14/2022] Open
Abstract
As the pandemic continues, individuals with re-detectable positive (RP) SARS-CoV-2 viral RNA among recovered COVID-19 patients have raised public health concerns. It is imperative to investigate whether the cases with re-detectable positive (RP) SARS-CoV-2 might cause severe infection to the vulnerable population. In this work, we conducted a systematic review of recent literature to investigate reactivation and reinfection among the discharged COVID-19 patients that are found positive again. Our study, consisting more than a total of 113,715 patients, indicates that the RP-SARS-CoV-2 scenario occurs plausibly due to reactivation, reinfection, viral shedding, or testing errors. Nonetheless, we observe that previously infected individuals have significantly lower risk of being infected for the second time, indicating that reactivation or reinfection of SARS-CoV-2 likely have relatively less impact in the general population than the primary infection.
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Affiliation(s)
- Xiujuan Tang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Salihu S Musa
- Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong, China.,Department of Mathematics, Kano University of Science and Technology, Wudil, Nigeria
| | - Shi Zhao
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute of Chinese University of Hong Kong, Shenzhen, China
| | - Daihai He
- Department of Applied Mathematics, The Hong Kong Polytechnic University, Hong Kong, China
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12
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Nicholson EG, Avadhanula V, Fragoso S, Stroh R, Ye X, Bond N, Santarcangelo P, Stroh J, Piedra PA. SARS-CoV-2 re-infection versus prolonged shedding: A case series. Influenza Other Respir Viruses 2021; 15:691-696. [PMID: 34085762 PMCID: PMC8242882 DOI: 10.1111/irv.12879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/16/2021] [Indexed: 01/15/2023] Open
Abstract
Since the start of the SARS‐CoV‐2 pandemic, it has been difficult to differentiate between SARS‐CoV‐2 re‐infection and prolonged RNA shedding. In this report, we identified patients with positive RT‐PCR results for SARS‐CoV‐2 ≥70 days apart. Clinical and laboratory data were collected and criteria were applied to discern whether the presentation was consistent with SARS‐CoV‐2 re‐infection or prolonged viral RNA shedding. Eleven individuals met the initial testing criteria, of which, seven met at least one criteria for re‐infection and four were consistent with prolonged RNA shedding. These data demonstrate the need for criteria to differentiate SARS‐CoV‐2 re‐infection from prolonged RNA shedding.
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Affiliation(s)
- Erin G Nicholson
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Vasanthi Avadhanula
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Sonia Fragoso
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Rachel Stroh
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Xunyan Ye
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Nanette Bond
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Patricia Santarcangelo
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - John Stroh
- Department of Emergency Medicine, St. Luke's Health, Houston, TX, USA
| | - Pedro A Piedra
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.,Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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13
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Bongiovanni M, Marra AM, Bini F, Bodini BD, Carlo DD, Giuliani G. COVID-19 reinfection in healthcare workers: A case series. J Infect 2021; 82:e4-e5. [PMID: 33839184 PMCID: PMC8026402 DOI: 10.1016/j.jinf.2021.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Marco Bongiovanni
- Pneumology Unit, Department of Medicine, Ospedale Salvini, Garbagnate Milanese, ASST, Rhodense, Milan, Italy.
| | - Alessandro Maria Marra
- Pneumology Unit, Department of Medicine, Ospedale Salvini, Garbagnate Milanese, ASST, Rhodense, Milan, Italy
| | - Francesco Bini
- Pneumology Unit, Department of Medicine, Ospedale Salvini, Garbagnate Milanese, ASST, Rhodense, Milan, Italy
| | - Bruno Dino Bodini
- Pneumology Unit, Department of Medicine, Ospedale Salvini, Garbagnate Milanese, ASST, Rhodense, Milan, Italy
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14
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Candoni A, Pizzano U, Fabris M, Curcio F, Fanin R. Seroconversion and kinetic of anti SARS-COV-2 antibodies in 25 patients with hematological malignancies who recovered from SARS-COV-2 infection. Hematol Oncol 2021; 39:428-431. [PMID: 33951220 PMCID: PMC8239694 DOI: 10.1002/hon.2872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/17/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Anna Candoni
- Division of Hematology and SCT, University of Udine and ASUFC, Udine, Italy
| | - Umberto Pizzano
- Division of Hematology and SCT, University of Udine and ASUFC, Udine, Italy
| | - Martina Fabris
- Department of Medicine and Clinical Pathology Institute, University of Udine and ASUFC, Udine, Italy
| | - Francesco Curcio
- Department of Medicine and Clinical Pathology Institute, University of Udine and ASUFC, Udine, Italy
| | - Renato Fanin
- Division of Hematology and SCT, University of Udine and ASUFC, Udine, Italy
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15
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Piri SM, Edalatfar M, Shool S, Jalalian MN, Tavakolpour S. A systematic review on the recurrence of SARS-CoV-2 virus: frequency, risk factors, and possible explanations. Infect Dis (Lond) 2021; 53:315-324. [PMID: 33508989 PMCID: PMC7852280 DOI: 10.1080/23744235.2020.1871066] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Since late 2019, SARS-CoV-2 which leads to coronavirus disease 2019 (COVID-19), has caused thousands of deaths. There are some pieces of evidence that SARS-CoV-2 genome could be re-detectable in recovered patients. METHODS We performed a systematic review in the PubMed/Medline database to address the risk of SARS-CoV-2 recurrence. The last update was for 20 November 2020. Among the 1178 initially found articles, 66 met the inclusion criteria and were considered. FINDINGS In total, 1128 patients with at least one-time recurrence of SARS-CoV-2 were included. Recurrence rate has been reported between 2.3% and 21.4% in cohort studies, within a mean of 20 (ranged 1-98) days after discharge; younger patients are being affected more. Following the second course of disease, the disease severity decreased or remained unchanged in 97.3% while it increased in 2.6%. Anti-SARS-CoV-2 IgG and IgM were positive in 11-95% and 58.8-100%, respectively. Based on the literature, three possibilities include reactivation of previous disease, reinfection with the same virus, and false negative, which have been discussed in details. CONCLUSION There is a relatively notable risk of disease recurrence in previously recovered patients, even those who are immunised against the virus. More studies are required to clarify the underlying cause of this phenomenon.
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Affiliation(s)
- Seyed Mohammad Piri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Edalatfar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Shool
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Soheil Tavakolpour
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA,CONTACT Soheil Tavakolpour Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Yavuz E, Basbulut E. A Possible COVID-19 Reinfection Case in a Healthcare Professional. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In these days when the effect of the COVID-19 pandemic is felt with all its severity, the findings of re-infection in people who have had COVID-19 disease have led to some questions about the natural immunity against this disease. Here, we report a possible COVID-19 reinfection. The second episode confirmed by RT-PCR with a more severe clinical picture one month after an incidentally detected first episode with mild symptoms of a doctor working as a microbiologist at a training research hospital. While a 47-year-old female doctor was working in a tertiary hospital serving as a reference hospital for the diagnosis and treatment of COVID-19 patients, symptoms of sore throat, cough and runny nose appeared on October 25. The patient, with a history of chronic tendinitis, COPD, asthma and allergic rhinitis, attributed these symptoms to her previous clinical diagnosis and did not consider consulting a doctor or testing for COVID-19 due to the mild course of symptoms. SARS-CoV-2 Ig G antibodies were found to be positive in a screening study conducted on November 11 in the patient whose complaints resolved within a few days. RT-PCR performed thereafter was reported as negative. The RT-PCR test performed on December 2 of the patient who complained of fever and severe weakness, immediately after her colleague had COVID-19, was interpreted as positive. No signs of viral pneumonia were found in the thoracic CT when the cough complaint of the patient who received COVID-19 treatment did not improve. The patient's complaints regressed with the addition of phenocodine to her treatment, and the RT-PCR test on December 12 was reported as negative. Further analysis of the frequency and possible causes of COVID-19 reinfections will be needed in the near future.
Keywords: SARS-CoV-2, COVID-19, reinfection, coronavirus
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Affiliation(s)
- Erdinc Yavuz
- Department of Family Medicine, Samsun Training and Research Hospital
| | - Ese Basbulut
- Department of Microbiology, Samsun Training and Research Hospital
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17
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Abstract
Background: Previous studies reported the recurrence of coronavirus disease 2019 (COVID-19) among discharge patients. This study aimed to examine the characteristic of COVID-19 recurrence cases by performing a systematic review and meta-analysis. Methods: A systematic search was performed in PubMed and Embase and gray literature up to September 19, 2020. A random-effects model was applied to obtain the pooled prevalence of disease recurrence among recovered patients and the prevalence of subjects underlying comorbidity among recurrence cases. The other characteristics were calculated based on the summary data of individual studies. Results: A total of 41 studies were included in the final analysis, we have described the epidemiological characteristics of COVID-19 recurrence cases. Of 3,644 patients recovering from COVID-19 and being discharged, an estimate of 15% (95% CI, 12% to 19%) patients was re-positive with SARS-CoV-2 during the follow-up. This proportion was 14% (95% CI, 11% to 17%) for China and 31% (95% CI, 26% to 37%) for Korea. Among recurrence cases, it was estimated 39% (95% CI, 31% to 48%) subjects underlying at least one comorbidity. The estimates for times from disease onset to admission, from admission to discharge, and from discharge to RNA positive conversion were 4.8, 16.4, and 10.4 days, respectively. Conclusion: This study summarized up-to-date evidence from case reports, case series, and observational studies for the characteristic of COVID-19 recurrence cases after discharge. It is recommended to pay attention to follow-up patients after discharge, even if they have been in discharge quarantine.
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18
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Azizi H, Esmaeili ED. Challenges and potential solutions in the development of COVID-19 pandemic control measures. New Microbes New Infect 2021; 40:100852. [PMID: 33643657 PMCID: PMC7902202 DOI: 10.1016/j.nmni.2021.100852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 12/21/2022] Open
Abstract
The coronavirus disease 2019 pandemic has become an unprecedented and major health concern all over the world. We discuss potential solutions and feasible strategies to reduce spread of infection and to develop disease control measures.
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Affiliation(s)
- H. Azizi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran
- Research Centre of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - E. Davtalab Esmaeili
- Road Traffic Injury Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
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19
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IgM and IgG Profiles Reveal Peculiar Features of Humoral Immunity Response to SARS-CoV-2 Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031318. [PMID: 33535692 PMCID: PMC7908175 DOI: 10.3390/ijerph18031318] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 12/23/2022]
Abstract
The emergence of coronavirus disease 2019 (COVID-19) is globally a major healthcare threat. There is little information regarding the mechanisms and roles of the humoral response in SARS-CoV-2 infection. The aim of this study was to analyze the antibody levels (IgM and IgG) by chemiluminescence immunoassay in 54 subjects positive to SARS-CoV-2 swab test in relation to their clinical status (whether asymptomatic, pauci-symptomatic or with mild, sever or critical symptoms), the time from the symptom onset, sex, age, and comorbidities. Overall, the presence of comorbidities and the age of subjects were associated with their clinical status. The IgG concentrations were significantly higher in patients who developed critical and severe symptoms and seemed to be independent from age, sex and comorbidities. IgG titers peaked around day 60, and then began gradually to drop, decreasing by approximately 50% on the 180th day, while the IgM titers progressively decreased as early as the tenth day, but they could be detected even at later time points. Despite the small number of individuals, some peculiar characteristics of the humoral response in COVID-19 emerged. We observed a high inter-individual variability, an ephemeral IgG half-life in several patients, and a persistence of IgM in others.
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20
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Gidari A, Nofri M, Saccarelli L, Bastianelli S, Sabbatini S, Bozza S, Camilloni B, Fusco-Moffa I, Monari C, De Robertis E, Mencacci A, Francisci D. Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature. Eur J Clin Microbiol Infect Dis 2021; 40:1-12. [PMID: 33037944 PMCID: PMC7547550 DOI: 10.1007/s10096-020-04057-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022]
Abstract
Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.
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Affiliation(s)
- Anna Gidari
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy.
| | - Marco Nofri
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Luca Saccarelli
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Sabrina Bastianelli
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Samuele Sabbatini
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Silvia Bozza
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Barbara Camilloni
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Igino Fusco-Moffa
- Department of Prevention, Local Health Unit Umbria 1, Travel Medicine Unit, Perugia, Italy
| | - Claudia Monari
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Edoardo De Robertis
- Department of Anesthesiology, Intensive Care and Pain therapy Center, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
| | - Antonella Mencacci
- Department of Medicine, Medical Microbiology Section, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Department of Medicine, Clinic of Infectious Diseases, "Santa Maria della Misericordia" Hospital, University of Perugia, Perugia, Italy
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21
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SeyedAlinaghi S, Oliaei S, Kianzad S, Afsahi AM, MohsseniPour M, Barzegary A, Mirzapour P, Behnezhad F, Noori T, Mehraeen E, Dadras O, Voltarelli F, Sabatier JM. Reinfection risk of novel coronavirus (COVID-19): A systematic review of current evidence. World J Virol 2020; 9:79-90. [PMID: 33363000 PMCID: PMC7747024 DOI: 10.5501/wjv.v9.i5.79] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/23/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019 (CoVID-19) patients. AIM To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease. METHODS This study was a systematic review of current evidence conducted in August 2020. The authors studied the probable reinfection risk of novel coronavirus (CoVID-19). We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of this study and results. RESULTS We reviewed 31 studies. Eight studies described reCoVered patients with reinfection. Only one study reported reinfected patients who died. In 26 studies, there was no information about the status of the patients. Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short. CONCLUSION Based on our review, we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease. Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran 1586489615, Iran
| | - Shahram Oliaei
- HBOT Research Center, Golestan Hospital, Islamic Republic of Iran, Navy and AJA Medical University, Tehran 7134845794, Iran
| | - Shaghayegh Kianzad
- School of Medicine, Iran University of Medical Sciences, Tehran 7134845794, Iran
| | - Amir Masoud Afsahi
- Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, CA 587652458, United States
| | - Mehrzad MohsseniPour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran 1586489615, Iran
| | - Alireza Barzegary
- School of Medicine, Islamic Azad University, Tehran 7134845794, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran 1586489615, Iran
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran 7134845794, Iran
| | - Tayebeh Noori
- Department of Health Information Technology, Zabol University of Medical Sciences, Zabol 5486952364, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal 1419733141, Iran
| | - Omid Dadras
- Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto 215789652, Japan
| | - Fabricio Voltarelli
- Graduation Program of Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá 458796523, Brazil
| | - Jean-Marc Sabatier
- Université Aix-Marseille, Institutde Neuro-physiopathologie (INP), UMR 7051, Faculté de Pharmacie, 27 Bd Jean Moulin, Marseille 546789235, France
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22
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Gao Z, Xu Y, Guo Y, Xu D, Zhang L, Wang X, Sun C, Qiu S, Ma K. A systematic review of re-detectable positive virus nucleic acid among COVID-19 patients in recovery phase. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2020; 85:104494. [PMID: 32763440 PMCID: PMC7403029 DOI: 10.1016/j.meegid.2020.104494] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 12/15/2022]
Abstract
A large number of coronavirus disease 2019 (COVID-19) patients have been cured and discharged due to timely and effective treatments. While some discharged patients have been found re-positive nucleic acid again in the recovery phase. Until now, there is still a great challenge to its infectivity and the specific potential mechanism which needs further discussion. However, more intensive attention should be paid to the prognosis of recovered patients. In this review, we mainly focus on the characteristics, potential reasons, infectivity, and outcomes of re-detectable positive patients, thereby providing some novel insights into the cognition of COVID-19.
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Affiliation(s)
- Zhiru Gao
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Yinghui Xu
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Ye Guo
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Dongsheng Xu
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Li Zhang
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Xu Wang
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Chao Sun
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Shi Qiu
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Kewei Ma
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin 130021, China.
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23
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Hanif M, Haider MA, Ali MJ, Naz S, Sundas F. Reinfection of COVID-19 in Pakistan: A First Case Report. Cureus 2020; 12:e11176. [PMID: 33262913 PMCID: PMC7689968 DOI: 10.7759/cureus.11176] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 01/07/2023] Open
Abstract
Since its spread across the world, coronavirus disease 2019 (COVID-19) has posed a severe public health threat, and many unanswered questions about COVID-19 remain. Antibodies have been detected a few days after the onset of infection, and in some patients, these antibodies wane quickly. To date, it is unknown whether all infected patients induce an adequate protective immune response or how long this effect remains. Here, a first case report of COVID-19 reinfection in Pakistan is reported within two months of complete recovery from the first severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection - confirmed with two sequential negative nasopharyngeal swabs.
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Affiliation(s)
- Muhammad Hanif
- Internal Medicine, Khyber Medical College, Peshawar, PAK
| | | | - Mukarram Jamat Ali
- Internal Medicine, King Edward Medical University/Mayo Hospital, Lahore, PAK
| | - Sidra Naz
- Internal Medicine, University of Health Sciences, Lahore, PAK
| | - Fnu Sundas
- Internal Medicine, Khyber Medical College, Peshawar, PAK
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24
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de Brito CAA, Lima PMA, de Brito MCM, de Oliveira DB. Second Episode of COVID-19 in Health Professionals: Report of Two Cases. Int Med Case Rep J 2020; 13:471-475. [PMID: 33061670 PMCID: PMC7537988 DOI: 10.2147/imcrj.s277882] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/10/2020] [Indexed: 01/27/2023] Open
Abstract
Although primary infection has been shown to prevent reinfection of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in animal models, gaps in the understanding of the immune response to the virus have not been adequately addressed, and some cases of possible reinfection have been reported; however, the frequency, relevance and proof of these events have yet to be determined. We report cases of two doctors who had two episodes of COVID-19 with positive RT-PCR (reverse transcriptase polymerase chain reaction) test results, raising the probability of reinfection. Case 1 was a 40-year-old male physician who presented fever and respiratory symptoms on April 10, with a positive RT-PCR test for SARS-CoV-2, with complete improvement of symptoms in five days. After 44 days, the patient presented the same symptoms of the previous episode, associated with anosmia and dysgeusia. The results of a new RT-PCR test performed two days later were positive for SARS-CoV-2. Case 2 was a 44-year-old female physician who worked in a reference clinic for COVID-19 (coronavirus disease 2019) and had onset of symptoms indicative of the disease on April 30. The RT-PCR test was positive for SARS-CoV-2, with improvement of symptoms in six days. On May 24, the patient presented fever, cough, and sore throat accompanied by headache, asthenia, myalgia, and diarrhea, and in this new episode, anosmia and dysgeusia were also present. A new RT-PCR test from nasopharyngeal swabs was performed with a positive result. Our two patients described here and other patients with possible reinfection who are now being observed in clinical practice reinforce the need to expand the investigation. Then, if the risk of reinfection is confirmed, these findings will be relevant from a clinical-epidemiological perspective to define isolation strategies and develop vaccines.
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Affiliation(s)
- Carlos Alexandre Antunes de Brito
- Department of Internal Medicine, Center of Medical Sciences of Federal University, Recife, Pernambuco, Brazil.,Department of Immunology, Autoimmune Research Institute, Recife, Pernambuco, Brazil
| | - Petrus Moura Andrade Lima
- Department of Digestive Surgery, Institute of Integral Medicine Fernando Figueira (IMIP), Recife, Pernambuco, Brazil
| | - Marina Coelho Moraes de Brito
- Department of Immunology, Autoimmune Research Institute, Recife, Pernambuco, Brazil.,Center of Medical Sciences, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Bongiovanni M, Vignati M, Giuliani G, Manes G, Arienti S, Pelucchi L, Cattaneo N, Bodini BD, Clerici D, Rosa F, Pellegrini L, Schettino M, Picascia D, Bini F. The dilemma of COVID-19 recurrence after clinical recovery. J Infect 2020; 81:979-997. [PMID: 32810521 PMCID: PMC7428731 DOI: 10.1016/j.jinf.2020.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Marco Bongiovanni
- Internal Medicine Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy.
| | - Marco Vignati
- RSA Sandro Pertini, ASST Rhodense, Garbagnate Milanese, Milan, Italy
| | | | - Giampiero Manes
- Gastroenterology Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy
| | - Stefania Arienti
- RSA Sandro Pertini, ASST Rhodense, Garbagnate Milanese, Milan, Italy
| | - Loris Pelucchi
- RSA Sandro Pertini, ASST Rhodense, Garbagnate Milanese, Milan, Italy
| | | | - Bruno Dino Bodini
- Pneumology Unit, Department of Medicine, Ospedale Salvini Garbagnate Milanese, ASST Rhodense, Milan, Italy
| | - Danila Clerici
- RSA Sandro Pertini, ASST Rhodense, Garbagnate Milanese, Milan, Italy
| | - Fabio Rosa
- RSA Sandro Pertini, ASST Rhodense, Garbagnate Milanese, Milan, Italy
| | - Lucienne Pellegrini
- Gastroenterology Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy
| | - Mario Schettino
- Gastroenterology Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy
| | - Desiree Picascia
- Gastroenterology Unit, Department of Medicine, Ospedale di Circolo di Rho, ASST Rhodense, Milan, Italy
| | - Francesco Bini
- Pneumology Unit, Department of Medicine, Ospedale Salvini Garbagnate Milanese, ASST Rhodense, Milan, Italy
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Wiwanitkit V. Convalescent plasma therapy in the treatment of COVID-19: Some considerations: Correspondence. Int J Surg 2020; 80:26. [PMID: 32585194 PMCID: PMC7307978 DOI: 10.1016/j.ijsu.2020.06.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022]
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