Clinical, virologic and immunologic features of a mild case of SARS-CoV-2 reinfection

Ambosino

et al. 2021

IJERPH

Reinfection with SARS-CoV-2 seems to be a rare phenomenon. The objective of this study is to carry out a systematic search of literature on the SARS-CoV-2 reinfection in order to understand the success of the global vaccine campaigns. A systematic search was performed. Inclusion criteria included a positive RT-PCR test of more than 90 days after the initial test and the confirmed recovery or a positive RT-PCR test of more than 45 days after the initial test that is accompanied by compatible symptoms or epidemiological exposure, naturally after the confirmed recovery. Only 117 articles were included in the final review with 260 confirmed cases. The severity of the reinfection episode was more severe in 92/260 (35.3%) with death only in 14 cases. The observation that many reinfection cases were less severe than initial cases is interesting because it may suggest partial protection from disease. Another interesting line of data is the detection of different clades or lineages by genome sequencing between initial infection and reinfection in 52/260 cases (20%). The findings are useful and contribute towards the role of vaccination in response to the COVID-19 infections. Due to the reinfection cases with SARS-CoV-2, it is evident that the level of immunity is not 100% for all individuals. These data highlight how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all people after healing from COVID-19 or becoming asymptomatic positive.

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Reinfection Is a New Challenge for the Effectiveness of Global Vaccination Campaign: A Systematic Review of Cases Reported in Literature

Ambosino

et al. 2021

IJERPH

“…We note that the simulations in this work are based on the epidemic curve in Geneva, Switzerland, and that seroprevalence estimation bias caused by decaying sensitivity will depend on the timing of serosurveillance with respect to the number and amplitude of preceding epidemic waves, with larger and more distal waves being more severely under-estimated. Even for mild infections, which are thought to elicit less robust immune responses ( 24 ), the sensitivity of anti-RBD and anti-N total Ig Roche tests remained close to 100% after more than 8 months post-infection. These results suggest that both Roche immunoassays are suitable for seroprevalence estimation at longer times post-exposure.…”

Section: Discussionmentioning

confidence: 99%

Persistence and detection of anti-SARS-CoV-2 antibodies: immunoassay heterogeneity and implications for serosurveillance

Perez-Saez

Zaballa

Yerly

et al. 2021

Preprint

Self Cite

Serologic studies have been critical in tracking the evolution of the COVID-19 pandemic. The reliability of serologic studies for quantifying the proportion of the population that have been infected depends on the extent of antibody decay as well as on assay performance in detecting both recent and older infections. Data on anti-SARS-CoV-2 antibodies persistence remain sparse, especially from infected individuals with few to no symptoms. In a cohort of mostly mild/asymptomatic SARS-CoV-2-infected individuals tested with three widely-used immunoassays, antibodies persisted for at least 8 months after infection, although detection depended on immunoassay choice, with one of them missing up to 40% of past infections. Simulations reveal that without appropriate adjustment for time-varying assay sensitivity, seroprevalence surveys may underestimate infection rates. As the immune landscape becomes more complex with naturally-infected and vaccinated individuals, assay choice and appropriate assay-performance-adjustment will become even more important for the interpretation of serologic studies.

“…Seventy-two studies were determined to be of good quality while nine studies were of fair quality (S3 Table). Studies were primarily downgraded for unclear study objectives[63], incomplete case definition[16, 28, 48, 66, 67, 70, 77, 83], non-consecutive subject recruitment[19, 27, 30, 34, 38, 39, 44–46, 49, 71, 79, 80, 86, 90], incomparable subjects[79], inadequate length of follow-up[43, 63], inadequate description of statistical methods[39, 46, 80] and inadequate description of results[39, 78]. The most common cause for downgrading studies was non-consecutive recruitment which raised concerns that the included sample could be biased towards a more severe presentation or included more individuals undergoing routine screening.…”

Section: Resultsmentioning

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

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.