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- Title
Evidence of Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection After Recovery from Mild Coronavirus Disease 2019.
- Authors
Lee, Jee-Soo; Kim, So Yeon; Kim, Taek Soo; Hong, Ki Ho; Ryoo, Nam-Hee; Lee, Jaehyeon; Park, Jae Hyeon; Cho, Sung Im; Kim, Man Jin; Kim, Young-gon; Kim, Boram; Shin, Ho Seob; Oh, Hyeon Sae; Seo, Myoung-Seock; Gwon, Tae-Rin; Kim, Yeonjae; Park, Jun-Sun; Chin, Bum Sik; Park, Wan Beom; Park, Sung Sup
- Abstract
Background Positive results from real-time reverse-transcription polymerase chain reaction (rRT-PCR) in recovered patients raise concern that patients who recover from coronavirus disease 2019 (COVID-19) may be at risk of reinfection. Currently, however, evidence that supports reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not been reported. Methods We conducted whole-genome sequencing of the viral RNA from clinical specimens at the initial infection and at the positive retest from 6 patients who recovered from COVID-19 and retested positive for SARS-CoV-2 via rRT-PCR after recovery. A total of 13 viral RNAs from the patients' respiratory specimens were consecutively obtained, which enabled us to characterize the difference in viral genomes between initial infection and positive retest. Results At the time of the positive retest, we were able to acquire a complete genome sequence from patient 1, a 21-year-old previously healthy woman. In this patient, through the phylogenetic analysis, we confirmed that the viral RNA of positive retest was clustered into a subgroup distinct from that of the initial infection, suggesting that there was a reinfection of SARS-CoV-2 with a subtype that was different from that of the primary strain. The spike protein D614G substitution that defines the clade "G" emerged in reinfection, while mutations that characterize the clade "V" (ie, nsp6 L37F and ORF3a G251V) were present at initial infection. Conclusions Reinfection with a genetically distinct SARS-CoV-2 strain may occur in an immunocompetent patient shortly after recovery from mild COVID-19. SARS-CoV-2 infection may not confer immunity against a different SARS-CoV-2 strain.
- Subjects
SARS diagnosis; REVERSE transcriptase polymerase chain reaction; COVID-19; SEQUENCE analysis; CONVALESCENCE; REINFECTION; GENOMES; DESCRIPTIVE statistics; POLYMERASE chain reaction; DATA analysis software; DISEASE risk factors
- Publication
Clinical Infectious Diseases, 2021, Vol 73, Issue 9, pe3002
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciaa1421