tetano
Editor, Senior Moderator
Eur J Clin Microbiol Infect Dis
. 2020 Oct 10.
doi: 10.1007/s10096-020-04057-6. Online ahead of print.
Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature
Anna Gidari[SUP] 1 [/SUP], Marco Nofri[SUP] 2 [/SUP], Luca Saccarelli[SUP] 3 [/SUP], Sabrina Bastianelli[SUP] 2 [/SUP], Samuele Sabbatini[SUP] 4 [/SUP], Silvia Bozza[SUP] 4 [/SUP], Barbara Camilloni[SUP] 4 [/SUP], Igino Fusco-Moffa[SUP] 5 [/SUP], Claudia Monari[SUP] 4 [/SUP], Edoardo De Robertis[SUP] 3 [/SUP], Antonella Mencacci[SUP] 4 [/SUP], Daniela Francisci[SUP] 2 [/SUP]
Affiliations
Abstract
Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.
Keywords: COVID-19; Re-infection; Reactivation; Recurrence; SARS-CoV-2.
. 2020 Oct 10.
doi: 10.1007/s10096-020-04057-6. Online ahead of print.
Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature
Anna Gidari[SUP] 1 [/SUP], Marco Nofri[SUP] 2 [/SUP], Luca Saccarelli[SUP] 3 [/SUP], Sabrina Bastianelli[SUP] 2 [/SUP], Samuele Sabbatini[SUP] 4 [/SUP], Silvia Bozza[SUP] 4 [/SUP], Barbara Camilloni[SUP] 4 [/SUP], Igino Fusco-Moffa[SUP] 5 [/SUP], Claudia Monari[SUP] 4 [/SUP], Edoardo De Robertis[SUP] 3 [/SUP], Antonella Mencacci[SUP] 4 [/SUP], Daniela Francisci[SUP] 2 [/SUP]
Affiliations
- PMID: 33037944
- DOI: 10.1007/s10096-020-04057-6
Abstract
Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.
Keywords: COVID-19; Re-infection; Reactivation; Recurrence; SARS-CoV-2.