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Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration

A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a cli...

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Autores principales: Pedro, Nicole, Silva, Cláudio N., Magalhães, Ana C., Cavadas, Bruno, Rocha, Ana M., Moreira, Ana C., Gomes, Maria Salomé, Silva, Diogo, Sobrinho-Simões, Joana, Ramos, Angélica, Cardoso, Maria J., Filipe, Rita, Palma, Pedro, Ceia, Filipa, Silva, Susana, Guimarães, João T., Sarmento, António, Fernandes, Verónica, Pereira, Luisa, Tavares, Margarida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912897/
https://www.ncbi.nlm.nih.gov/pubmed/33540596
http://dx.doi.org/10.3390/microorganisms9020300
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author Pedro, Nicole
Silva, Cláudio N.
Magalhães, Ana C.
Cavadas, Bruno
Rocha, Ana M.
Moreira, Ana C.
Gomes, Maria Salomé
Silva, Diogo
Sobrinho-Simões, Joana
Ramos, Angélica
Cardoso, Maria J.
Filipe, Rita
Palma, Pedro
Ceia, Filipa
Silva, Susana
Guimarães, João T.
Sarmento, António
Fernandes, Verónica
Pereira, Luisa
Tavares, Margarida
author_facet Pedro, Nicole
Silva, Cláudio N.
Magalhães, Ana C.
Cavadas, Bruno
Rocha, Ana M.
Moreira, Ana C.
Gomes, Maria Salomé
Silva, Diogo
Sobrinho-Simões, Joana
Ramos, Angélica
Cardoso, Maria J.
Filipe, Rita
Palma, Pedro
Ceia, Filipa
Silva, Susana
Guimarães, João T.
Sarmento, António
Fernandes, Verónica
Pereira, Luisa
Tavares, Margarida
author_sort Pedro, Nicole
collection PubMed
description A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a clinically severe and prolonged viral shedding coronavirus disease 2019 (COVID-19) case in a 17-year-old Portuguese female. She had two hospitalizations, a total of 19 RT-PCR tests, mostly positive, and criteria for releasing from home isolation at the end of 97 days. The viral genome was sequenced in seven serial samples and in the diagnostic sample from her infected mother. A human genome-wide array (>900 K) was screened on the seven samples, and in vitro culture was conducted on isolates from three late samples. The patient had co-infection by two SARS-CoV-2 lineages, which were affiliated in distinct clades and diverging by six variants. The 20A lineage was absolute at the diagnosis (shared with the patient’s mother), but nine days later, the 20B lineage had 3% frequency, and two months later, the 20B lineage had 100% frequency. The 900 K profiles confirmed the identity of the patient in the serial samples, and they allowed us to infer that she had polygenic risk scores for hospitalization and severe respiratory disease within the normal distributions for a Portuguese population cohort. The early-on dynamic co-infection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile.
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spelling pubmed-79128972021-02-28 Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration Pedro, Nicole Silva, Cláudio N. Magalhães, Ana C. Cavadas, Bruno Rocha, Ana M. Moreira, Ana C. Gomes, Maria Salomé Silva, Diogo Sobrinho-Simões, Joana Ramos, Angélica Cardoso, Maria J. Filipe, Rita Palma, Pedro Ceia, Filipa Silva, Susana Guimarães, João T. Sarmento, António Fernandes, Verónica Pereira, Luisa Tavares, Margarida Microorganisms Article A few molecularly proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases of symptomatic reinfection are currently known worldwide, with a resolved first infection followed by a second infection after a 48 to 142-day intervening period. We report a multiple-component study of a clinically severe and prolonged viral shedding coronavirus disease 2019 (COVID-19) case in a 17-year-old Portuguese female. She had two hospitalizations, a total of 19 RT-PCR tests, mostly positive, and criteria for releasing from home isolation at the end of 97 days. The viral genome was sequenced in seven serial samples and in the diagnostic sample from her infected mother. A human genome-wide array (>900 K) was screened on the seven samples, and in vitro culture was conducted on isolates from three late samples. The patient had co-infection by two SARS-CoV-2 lineages, which were affiliated in distinct clades and diverging by six variants. The 20A lineage was absolute at the diagnosis (shared with the patient’s mother), but nine days later, the 20B lineage had 3% frequency, and two months later, the 20B lineage had 100% frequency. The 900 K profiles confirmed the identity of the patient in the serial samples, and they allowed us to infer that she had polygenic risk scores for hospitalization and severe respiratory disease within the normal distributions for a Portuguese population cohort. The early-on dynamic co-infection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile. MDPI 2021-02-02 /pmc/articles/PMC7912897/ /pubmed/33540596 http://dx.doi.org/10.3390/microorganisms9020300 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pedro, Nicole
Silva, Cláudio N.
Magalhães, Ana C.
Cavadas, Bruno
Rocha, Ana M.
Moreira, Ana C.
Gomes, Maria Salomé
Silva, Diogo
Sobrinho-Simões, Joana
Ramos, Angélica
Cardoso, Maria J.
Filipe, Rita
Palma, Pedro
Ceia, Filipa
Silva, Susana
Guimarães, João T.
Sarmento, António
Fernandes, Verónica
Pereira, Luisa
Tavares, Margarida
Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title_full Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title_fullStr Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title_full_unstemmed Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title_short Dynamics of a Dual SARS-CoV-2 Lineage Co-Infection on a Prolonged Viral Shedding COVID-19 Case: Insights into Clinical Severity and Disease Duration
title_sort dynamics of a dual sars-cov-2 lineage co-infection on a prolonged viral shedding covid-19 case: insights into clinical severity and disease duration
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912897/
https://www.ncbi.nlm.nih.gov/pubmed/33540596
http://dx.doi.org/10.3390/microorganisms9020300
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