Genetic Evidence and Host Immune Response in Persons Reinfected with SARS-CoV-2, Brazil

Fintelman-Rodrigues, Natália; Silva, Aline P.D. da; Santos, Monique Cristina dos; Saraiva, Felipe B.; Ferreira, Marcelo Alves; Gesto, João Silveira Moledo; Rodrigues, D. B.; Vale, Andre M.; Azevedo, Isaclaudia G. de; Soares, Vinícius C.; Jiang, Hui; Tan, Hongdong; Tschoeke, Diogo; Sacramento, Carolina Q.; Bozza, Fernando A.; Morel, Carlos; Bozza, Patrı́cia T.; Souza, Thiago Moreno L.

doi:10.3201/eid2705.204912

Cited by 20 publications

(13 citation statements)

References 40 publications

(34 reference statements)

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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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“…We first evaluated the in vitro neutralizing activity against SARS-CoV-2 of equine sera collected after four to six immunizations (days 28-49 after the first immunization) using a microneutralization assay (Fintelman-Rodrigues et al, 2021). PRNT 50 titers (average values for all five horses) seemed to achieve a plateau of approximately 1:23,000 after the fourth immunization, whereas the more stringent PRNT 90 titers (average values for all five horses) still showed an ascendant trend over time, reaching an average PRNT 90 titer of 1:14,604 on day 49.…”

Section: Immunization With the Trimeric S Protein Induces High Titers...mentioning

confidence: 99%

Polyclonal F(ab’)2 fragments of equine antibodies raised against the spike protein neutralize SARS-CoV-2 variants with high potency

Cunha¹,

Stolet²,

Strauch³

et al. 2021

iScience

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We used the recombinant trimeric spike (S) glycoprotein in the prefusion conformation to immunize horses for the production of hyperimmune globulins against SARS-CoV-2. Serum antibody titers measured by ELISA were above 1:10 6 , and the neutralizing antibody titer against authentic virus (WT) was 1:14,604 (average PRNT 90 ). Plasma from immunized animals was pepsin digested to remove the Fc portion and purified, yielding an F(ab’) 2 preparation with PRNT 90 titers 150-fold higher than the neutralizing titers in human convalescent plasma. Challenge studies were carried out in hamsters and showed the in vivo ability of equine F(ab’) 2 to reduce viral load in the pulmonary tissues and significant clinical improvement determined by weight gain. The neutralization curve by F(ab’) 2 was similar against WT and P.2 variant but displaced to higher concentrations by 0.39 log units against P.1 (Gamma) variant. These results support the possibility of using equine F(ab’) 2 preparation for the clinical treatment of COVID patients.

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“…[ 6 ] However, the actual evidence suggests that are features that increase the likelihood of a reinfection: Immunosuppressive conditions, new variants of concern, a longer time interval since the first infection, a high viral RNA level on repeat testing or undetectable blood anti-IgG antibodies. [ 3 4 ] Our cases match two of these features: They had no detectable blood anti-IgG antibody and a long interval since first infection, at the time when reinfection was considered. Given that both diagnoses were done at a primary care level and symptoms were not severe, we were not able to measure viral RNA level or request genomic sequencing, which are not available at this level of care.…”

Section: Discussionmentioning

confidence: 61%

“…Implications to public health management, namely the likelihood of transmissibility, of a possible reinfection remain unknown. [ 2 3 ] Hereby, we report two cases recovered from COVID-19, followed in primary care that showed once again symptoms and a positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test. These cases expand the scarce published data, highlighting the importance of taking preventive measures, and enhance the role of primary care as the first line against COVID-19 reinfection.…”

Section: Introductionmentioning

confidence: 99%

Reinfection with SARS-CoV-2: An inconvenient truth?

Manuel-Silva

Sonié²,

Rafael³

et al. 2022

J Family Med Prim Care

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Data show that antibody-related immunity against SARS-CoV-2 may not be long-lasting. We report two cases regarded as cured from COVID-19, which presented again with symptoms and a positive SARS-CoV-2 RT-PCR test. Case one, a 60-year-old male, had a biphasic presentation of symptoms compatible with COVID-19 infection, associated with a positive RT-PCR test. Case two, a 25-year-old female, had a first positive RT-PCR test during hospital screening, and months later a symptomatic presentation of COVID-19, associated with a positive RT-PCR test. All cases were immunocompetent. Anti-IgG-SARS-CoV-2 blood samples were negative in both. Elevation of analytical inflammatory markers suggested new infection in both cases. COVID-19 reinfection may be a differential diagnosis and primary care physicians should acknowledge it. Previously cured patients should be encouraged to comply with health public preventive measures.

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Genetic Evidence and Host Immune Response in Persons Reinfected with SARS-CoV-2, Brazil

Cited by 20 publications

References 40 publications

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection Cases Corroborated by Sequencing

Polyclonal F(ab’)2 fragments of equine antibodies raised against the spike protein neutralize SARS-CoV-2 variants with high potency

Reinfection with SARS-CoV-2: An inconvenient truth?

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