Produção Nacional
Viral Genetic Evidence and Host Immune Response of a Small Cluster of Individuals with Two Episodes of SARS-CoV-2 Infection
2020; RELX Group (Netherlands); Linguagem: Inglês
10.2139/ssrn.3750109
ISSN1556-5068
AutoresNatália Fintelman-Rodrigues, Aline de Paula Dias da Silva, Monique Cristina dos Santos, Felipe Saraiva, Marcelo Alves Ferreira, João Silveira Moledo Gesto, Danielle A.S. Rodrigues, André M. Vale, Isaclaudia Gomes de Azevedo, Vinícius Cardoso Soares, Hui Jiang, Hongdong Tan, Diogo A. Tschoeke, Carolina Q. Sacramento, Fernando A. Bozza, Carlos Morel, Patrı́cia T. Bozza, Thiago Moreno L. Souza,
Tópico(s)COVID-19 Clinical Research Studies
ResumoBackground: The dynamics underlying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection remains poorly understood. We added to the registered case reports of reinfection in USA, Belgium/Netherlands, Ecuador and Hong Kong, a small cluster of individuals with two episodes of 2019 coronavirus disease (COVID-19). Virus genomic analysis and the host immune response were used to characterize this group. Methods: Four individuals from Rio de Janeiro, Brazil, with clinical manifestations of COVID-19 on March and again in late May of 2020 were studied. Nasopharyngeal swabs were collected for RT-PCR and viral genome sequencing (BGI-MGI-2000). Plasma samples from the acute and convalescent phases of both infection episodes were accessed to document innate and humoral responses.Findings: After approximately 60 days of the first diagnostic episode of SARS-CoV-2 infection, the four individuals presented new clinical and molecular evidence of COVID-19. Complete SARS-CoV-2 genome sequence provided genetic evidence of reinfection. The individuals presented an enhanced innate response compared to healthy SARS-CoV-2 negative controls. Patients did not develop a neutralizing humoral immunity, possibly remaining susceptible to another episode of COVID-19. The second episode, associated with higher viral loads and clinical symptoms, likely boosted their anti-SARS-CoV-2 humoral response. Interpretation: SARS-CoV-2 reinfection was fully documented by identification of genetically distinct virus sequences in the first and second episodes for two individuals. The quantity of SARS-CoV-2-associated genetic reads and coverage of virus genome ruled out that the initial RT-PCR results were false positive. The identification that some individuals with mild COVID-19 may have controlled SARS-CoV-2 replication without developing detectable humoral immunity, opens the possibility that reinfection may be more frequent than supposed – but weakly documented.
Referência(s)