SARS-CoV-2 re-infection: development of an epidemiological definition from India

Abstract

The current investigation was conducted with the objective to develop an epidemiological case definition of possible severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) re-infection and assess its magnitude in India. The epidemiological case definition for SARS-CoV-2 re-infection was developed from literature review of data on viral kinetics. For achieving second objective, the individuals who satisfied the developed case definition for SARS-CoV-2 re-infection were contacted telephonically. Taking available evidence into consideration, re-infection with SARS-CoV-2 in our study was defined as any individual who tested positive for SARS-CoV-2 on two separate occasions by either molecular tests or rapid antigen test at an interval of at least 102 days with one negative molecular test in between. In this archive based, telephonic survey, 58 out of 1300 individuals (4.5%) fulfilled the above-mentioned definition; 38 individuals could be contacted with healthcare workers (HCWs) accounting for 31.6% of the cases. A large proportion of participants was asymptomatic and had higher Ct value during the first episode. While SARS-CoV-2 re-infection is still a rare phenomenon, there is a need for epidemiological definition of re-infection for establishing surveillance systems and this study contributes to such a goal. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) re-infection is an emerging concern and there is a need to define it. Therefore, working epidemiological case definition for re-infection was developed and its magnitude was explored via archive-based, telephonic survey. Re-infection with SARS-CoV-2 was defined as two positive tests at an interval of at least 102 days with one interim negative test. Thirty-eight of the 58 eligible patients could be contacted with 12 (31.6%) being HCWs. Majority of the participants were asymptomatic and had higher Ct value during their first episode. To conclude, a working epidemiological case definition of SARS-CoV-2 re-infection is important to strengthen surveillance. The present investigation contributes to this goal and records reinfection in 4.5% of SARS-CoV-2 infected individuals in India.

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“…8 A study by Mukherjee et al has provided evidence on COVID-19 reinfections in India and the potential threat to vaccinated individuals. 25 Age distribution pattern of deceased individuals infected with the top five SARS-COV-2 variants. Exploratory studies on the genomic and pathogenic properties of newly emerged SARS-COV-2 variants are progressing in tandem with the paucity of information on epidemiological characteristics, clinical outcomes, and mortality, particularly among patients infected with these newly emerged variants.…”

Clinical Characterization and Genomic Analysis of Samples from COVID-19 Breakthrough Infections during the Second Wave among the Various States of India

“…All of them subsequently received two doses of Covishield/AstraZeneca. The Indian Council of Medical Research had earlier conducted a study that defined re-infection as positive test for SARS-CoV-2 on two separate occasions by either molecular or rapid antigen test at an interval of at least 102 days, with one negative molecular test in between [ 25 ]. While we could not elicit history of a negative test result following the first episode of COVID-19 infection, the gap between two positive tests was well above 102 days in 11 cases.…”

SARS-CoV-2 re-infection rate in Iranian COVID-19 cases within one-year follow-up

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