Re-infection with a different SARS-CoV-2 clade and prolonged viral shedding in a hematopoietic stem cell transplantation patient

Alshukairi, Abeer N.; El-Kafrawy, Sherif A.; Dada, Ashraf; Yasir, Muhammad; Yamani, Amani; Saeedi, Mohammed F.; Aljohaney, Ahmed A.; AlJohani, Naif I.; Bahaudden, Husam A.; Álam, Intikhab; Gojobori, Takashi; Radovanović, Aleksandar; Alandijany, Thamir A.; Othman, Norah A.; Alsubhi, Tagreed L.; Hassan, Ahmed M.; Tolah, Ahmed M.; Al‐Tawfiq, Jaffar A.; Zumla, Alimuddin; Azhar, Esam I.

doi:10.1016/j.ijid.2021.07.036

Cited by 9 publications

(7 citation statements)

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“…In the present study, among confirmed reinfection cases with compatible symptoms in the second episode, two of them occurred as soon as 55 and 63 days (cases P9 and P16) after the first episode, but they were confirmed due to the higher number of mutations than the expected by the natural evolution of the virus. This higher number of mutations has already been observed in other cases of reinfections reported worldwide ( Alshukairi et al, 2021 ; Lee J.-S. et al, 2021 ; Selhorst et al, 2021 ; Rahman et al, 2022 ), and some reports use it as evidence of reinfection ( Sevillano et al, 2021 ; Tillett et al, 2021 ). On the other hand, cases P20 and P22 (occurring with an interval of 192 and 297 days, respectively) did not have a higher number of mutations than the expected.…”

Section: Discussionsupporting

confidence: 68%

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

et al. 2022

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BackgroundSince the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the main concern is whether reinfections are possible, and which are the associated risk factors. This study aims to describe the clinical and molecular characteristics of 24 sequence-confirmed reinfection SARS-CoV-2 cases over 1 year in Barcelona (Catalonia, Spain).MethodsPatients with > 45 days between two positive PCR tests regardless of symptoms and negative tests between episodes were initially considered as suspected reinfection cases from November 2020 to May 2021. Whole-genome sequencing (WGS) was performed to confirm genetic differences between consensus sequences and for phylogenetic studies based on PANGOLIN nomenclature. Reinfections were confirmed by the number of mutations, change in lineage, or epidemiological criteria.ResultsFrom 39 reported suspected reinfection cases, complete viral genomes could be sequenced from both episodes of 24 patients, all were confirmed as true reinfections. With a median age of 44 years (interquartile range [IQR] 32–65), 66% were women and 58% were healthcare workers (HCWs). The median days between episodes were 122 (IQR 72–199), occurring one-third within 3 months. Reinfection episodes were frequently asymptomatic and less severe than primary infections. The absence of seroconversion was associated with symptomatic reinfections. Only one case was reinfected with a variant of concern (VOC).ConclusionSevere acute respiratory syndrome coronavirus 2 reinfections can occur in a shorter time than previously reported and are mainly found in immunocompetent patients. Surveillance through WGS is useful to identify viral mutations associated with immune evasion.

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Section: Discussionsupporting

confidence: 68%

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

et al. 2022

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“…Seven patients died (aged 44-92): one died of septic shock and respiratory failure [10], another one died of respiratory failure [77], and the cause of death was not reported for the remaining five patients [43,44,54,75]. Five patients were reported as still being hospitalized [38,41,61], and five patients had been discharged from hospital [35,42,52,66].…”

Section: Patient Outcomesmentioning

confidence: 99%

Reinfection in patients with COVID-19: a systematic review

Ren

Zhou

Guo

et al. 2022

glob health res policy

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Background With the continuation of the COVID-19 pandemic, some COVID-19 patients have become reinfected with the virus. Viral gene sequencing has found that some of these patients were reinfected by the different and others by same strains. This has raised concerns about the effectiveness of immunity after infection and the reliability of vaccines. To this end, we conducted a systematic review to assess the characteristics of patients with reinfection and possible causes. Methods A systematic search was conducted across eight databases: PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang, VIP and SinoMed from December 1, 2019 to September 1, 2021. The quality of included studies were assessed using JBI critical appraisal tools and Newcastle–Ottawa Scale. Results This study included 50 studies from 20 countries. There were 118 cases of reinfection. Twenty-five patients were reported to have at least one complication. The shortest duration between the first infection and reinfection was 19 days and the longest was 293 days. During the first infection and reinfection, cough (51.6% and 43.9%) and fever (50% and 30.3%) were the most common symptoms respectively. Nine patients recovered, seven patients died, and five patients were hospitalized, but 97 patients’ prognosis were unknown. B.1 is the most common variant strain at the first infection. B.1.1.7, B.1.128 and B.1.351 were the most common variant strains at reinfection. Thirty-three patients were infected by different strains and 9 patients were reported as being infected with the same strain. Conclusions Our research shows that it is possible for rehabilitated patients to be reinfected by SARS-COV-2. To date, the causes and risk factors of COVID-19 reinfection are not fully understood. For patients with reinfection, the diagnosis and management should be consistent with the treatment of the first infection. The public, including rehabilitated patients, should be fully vaccinated, wear masks in public places, and pay attention to maintaining social distance to avoid reinfection with the virus.

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“…It has been also reported that the use of the anti-CD20 antibody rituximab, with or without chemotherapy, is typically associated with impaired humoral responses to influenza vaccines [38]. Similar cases are emerging with SARS-CoV-2 vaccines [39][40][41][42][43]. Rituximab is associated with B cell 141 depletion for up to 78 weeks following use.…”

Section: Discussionmentioning

confidence: 99%

“…Immunocompromised patients likely acquire different clades of SARS-CoV-2 45 infection. Moreover, they cannot respond to the Sars-Cov-2 vaccines [ 42 , 43 ]. Alshukairi et al [ 42 ] recently described the case of a 51-year-old female patient with a history of follicular non-Hodgkin’s lymphoma and rituximab therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, they cannot respond to the Sars-Cov-2 vaccines [ 42 , 43 ]. Alshukairi et al [ 42 ] recently described the case of a 51-year-old female patient with a history of follicular non-Hodgkin’s lymphoma and rituximab therapy. The patient did not develop immunity after SARS-CoV-2 infection and did not respond to the mRNA COVID-19 vaccine.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 Pneumonia in Vaccinated Population: A Six Clinical and Radiological Case Series

et al. 2021

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Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its related disease (COVID-19) continue to represent a challenge for humans. To date, vaccination programs have represented an opportunity to navigate the pandemic. However, the advent of new genetic COVID-19 variants has increased more attention representing a worrying threat not only for not vaccinated but also for vaccinated people as virus infections have been shown also in the last ones. Herein, we report different clinical cases and radiological findings of COVID-19 pneumonia in six fully vaccinated patients. Two patients had a history of Rituximab therapy for follicular lymphoma and with persistent positivity for SARS-CoV-2 on nasopharyngeal/oropharyngeal (NP/OP) swabs and with moderate pneumonia on the chest computed tomography (CT). One patient who resulted to be positive to delta variant 8 days after the second vaccination dose, died shortly after. Two patients were hospitalized due to the worsening of fever and dyspnea in presence of mild pneumonia on CT. In one patient mild pneumonia was found on the chest-CT performed after a lipothymic episode associated with chest pain and positive NP/OP swab tested for SARS-CoV-2. These data suggested that in fully vaccinated people, caution should be preserved, and the use of masks and social distancing should be continued in all closed environments. However, further clinical trials should be done to better understand how various factors can influence vaccine immunogenicity as the presence of virus mutations, age factors, and the presence of an immunocompromised state.

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Re-infection with a different SARS-CoV-2 clade and prolonged viral shedding in a hematopoietic stem cell transplantation patient

Abstract: Re-infection with different SARS-CoV-2 clade and prolonged viral shedding in a patient with hematopoietic stem cell transplantation,

Cited by 9 publications

References 10 publications

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

Characteristics of 24 SARS-CoV-2-Sequenced Reinfection Cases in a Tertiary Hospital in Spain

Reinfection in patients with COVID-19: a systematic review

COVID-19 Pneumonia in Vaccinated Population: A Six Clinical and Radiological Case Series

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