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author Adrielle dos Santos, Letícia
Filho, Pedro Germano de Góis
Silva, Ana Maria Fantini
Santos, João Victor Gomes
Santos, Douglas Siqueira
Aquino, Marília Marques
de Jesus, Rafaela Mota
Almeida, Maria Luiza Dória
da Silva, João Santana
Altmann, Daniel M.
Boyton, Rosemary J.
Alves dos Santos, Cliomar
Santos, Camilla Natália Oliveira
Alves, Juliana Cardoso
Santos, Ianaline Lima
Magalhães, Lucas Sousa
Belitardo, Emilia M.M.A.
Rocha, Danilo J.P.G.
Almeida, João P.P.
Pacheco, Luis G.C.
Aguiar, Eric R.G.R.
Campos, Gubio Soares
Sardi, Silvia Inês
Carvalho, Rejane Hughes
de Jesus, Amélia Ribeiro
Rezende, Karla Freire
de Almeida, Roque Pacheco
author_facet Adrielle dos Santos, Letícia
Filho, Pedro Germano de Góis
Silva, Ana Maria Fantini
Santos, João Victor Gomes
Santos, Douglas Siqueira
Aquino, Marília Marques
de Jesus, Rafaela Mota
Almeida, Maria Luiza Dória
da Silva, João Santana
Altmann, Daniel M.
Boyton, Rosemary J.
Alves dos Santos, Cliomar
Santos, Camilla Natália Oliveira
Alves, Juliana Cardoso
Santos, Ianaline Lima
Magalhães, Lucas Sousa
Belitardo, Emilia M.M.A.
Rocha, Danilo J.P.G.
Almeida, João P.P.
Pacheco, Luis G.C.
Aguiar, Eric R.G.R.
Campos, Gubio Soares
Sardi, Silvia Inês
Carvalho, Rejane Hughes
de Jesus, Amélia Ribeiro
Rezende, Karla Freire
de Almeida, Roque Pacheco
author_sort Adrielle dos Santos, Letícia
collection PubMed
description BACKGROUND: There is growing concern about individuals reported to suffer repeat COVID-19 disease episodes, these in a small number of cases characterised as de novo infections with distinct sequences, indicative of insufficient protective immunity even in the short term. METHODS: Observational case series and case-control studies reporting 33 cases of recurrent, symptomatic, qRT-PCR positive COVID-19. Recurrent disease was defined as symptomatic recurrence after symptom-free clinical recovery, with release from isolation >14 days from the beginning of symptoms confirmed by qRT-PCR. The case control study-design compared this group of patients with a control group of 62 patients randomly selected from the same COVID-19 database. RESULTS: Of 33 recurrent COVID-19 patients, 26 were female and 30 were HCW. Mean time to recurrence was 50.5 days which was associated with being a HCW (OR 36.4 (p <0.0001)), and blood type A (OR 4.8 (p = 0.002)). SARS-CoV-2 antibodies were signifcantly lower in recurrent patients after initial COVID-19  (2.4 ± 0.610; p<0.0001) and after recurrence (6.4 ± 11.34; p = 0.007).  Virus genome sequencing identified reinfection by a different isolate in one patient. CONCLUSIONS: This is the first detailed case series showing COVID-19 recurrence with qRT-PCR positivity. For one individual detection of phylogenetically distinct genomic sequences in the first and second episodes confirmed bona fide renfection, but in most cases the data do not formally distinguish between reinfection and re-emergence of a chronic infection reservoir. These episodes were significantly associated with reduced Ab response during initial disease and argue the need for ongoing vigilance without an assumption of protection after a first episode.
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spelling pubmed-78808342021-02-16 Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers Adrielle dos Santos, Letícia Filho, Pedro Germano de Góis Silva, Ana Maria Fantini Santos, João Victor Gomes Santos, Douglas Siqueira Aquino, Marília Marques de Jesus, Rafaela Mota Almeida, Maria Luiza Dória da Silva, João Santana Altmann, Daniel M. Boyton, Rosemary J. Alves dos Santos, Cliomar Santos, Camilla Natália Oliveira Alves, Juliana Cardoso Santos, Ianaline Lima Magalhães, Lucas Sousa Belitardo, Emilia M.M.A. Rocha, Danilo J.P.G. Almeida, João P.P. Pacheco, Luis G.C. Aguiar, Eric R.G.R. Campos, Gubio Soares Sardi, Silvia Inês Carvalho, Rejane Hughes de Jesus, Amélia Ribeiro Rezende, Karla Freire de Almeida, Roque Pacheco J Infect Article BACKGROUND: There is growing concern about individuals reported to suffer repeat COVID-19 disease episodes, these in a small number of cases characterised as de novo infections with distinct sequences, indicative of insufficient protective immunity even in the short term. METHODS: Observational case series and case-control studies reporting 33 cases of recurrent, symptomatic, qRT-PCR positive COVID-19. Recurrent disease was defined as symptomatic recurrence after symptom-free clinical recovery, with release from isolation >14 days from the beginning of symptoms confirmed by qRT-PCR. The case control study-design compared this group of patients with a control group of 62 patients randomly selected from the same COVID-19 database. RESULTS: Of 33 recurrent COVID-19 patients, 26 were female and 30 were HCW. Mean time to recurrence was 50.5 days which was associated with being a HCW (OR 36.4 (p <0.0001)), and blood type A (OR 4.8 (p = 0.002)). SARS-CoV-2 antibodies were signifcantly lower in recurrent patients after initial COVID-19  (2.4 ± 0.610; p<0.0001) and after recurrence (6.4 ± 11.34; p = 0.007).  Virus genome sequencing identified reinfection by a different isolate in one patient. CONCLUSIONS: This is the first detailed case series showing COVID-19 recurrence with qRT-PCR positivity. For one individual detection of phylogenetically distinct genomic sequences in the first and second episodes confirmed bona fide renfection, but in most cases the data do not formally distinguish between reinfection and re-emergence of a chronic infection reservoir. These episodes were significantly associated with reduced Ab response during initial disease and argue the need for ongoing vigilance without an assumption of protection after a first episode. The Authors. Published by Elsevier Ltd on behalf of The British Infection Association. 2021-03 2021-02-13 /pmc/articles/PMC7880834/ /pubmed/33589297 http://dx.doi.org/10.1016/j.jinf.2021.01.020 Text en © 2021 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Adrielle dos Santos, Letícia
Filho, Pedro Germano de Góis
Silva, Ana Maria Fantini
Santos, João Victor Gomes
Santos, Douglas Siqueira
Aquino, Marília Marques
de Jesus, Rafaela Mota
Almeida, Maria Luiza Dória
da Silva, João Santana
Altmann, Daniel M.
Boyton, Rosemary J.
Alves dos Santos, Cliomar
Santos, Camilla Natália Oliveira
Alves, Juliana Cardoso
Santos, Ianaline Lima
Magalhães, Lucas Sousa
Belitardo, Emilia M.M.A.
Rocha, Danilo J.P.G.
Almeida, João P.P.
Pacheco, Luis G.C.
Aguiar, Eric R.G.R.
Campos, Gubio Soares
Sardi, Silvia Inês
Carvalho, Rejane Hughes
de Jesus, Amélia Ribeiro
Rezende, Karla Freire
de Almeida, Roque Pacheco
Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title_full Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title_fullStr Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title_full_unstemmed Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title_short Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers
title_sort recurrent covid-19 including evidence of reinfection and enhanced severity in thirty brazilian healthcare workers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880834/
https://www.ncbi.nlm.nih.gov/pubmed/33589297
http://dx.doi.org/10.1016/j.jinf.2021.01.020
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