de Brito Carlos Alexandre Antunes, Lima Petrus Moura Andrade, de Brito Marina Coelho Moraes, de Oliveira Daniela Barbosa
Department of Internal Medicine, Center of Medical Sciences of Federal University, Recife, Pernambuco, Brazil.
Department of Immunology, Autoimmune Research Institute, Recife, Pernambuco, Brazil.
Int Med Case Rep J. 2020 Oct 2;13:471-475. doi: 10.2147/IMCRJ.S277882. eCollection 2020.
Although primary infection has been shown to prevent reinfection of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in animal models, gaps in the understanding of the immune response to the virus have not been adequately addressed, and some cases of possible reinfection have been reported; however, the frequency, relevance and proof of these events have yet to be determined. We report cases of two doctors who had two episodes of COVID-19 with positive RT-PCR (reverse transcriptase polymerase chain reaction) test results, raising the probability of reinfection. Case 1 was a 40-year-old male physician who presented fever and respiratory symptoms on April 10, with a positive RT-PCR test for SARS-CoV-2, with complete improvement of symptoms in five days. After 44 days, the patient presented the same symptoms of the previous episode, associated with anosmia and dysgeusia. The results of a new RT-PCR test performed two days later were positive for SARS-CoV-2. Case 2 was a 44-year-old female physician who worked in a reference clinic for COVID-19 (coronavirus disease 2019) and had onset of symptoms indicative of the disease on April 30. The RT-PCR test was positive for SARS-CoV-2, with improvement of symptoms in six days. On May 24, the patient presented fever, cough, and sore throat accompanied by headache, asthenia, myalgia, and diarrhea, and in this new episode, anosmia and dysgeusia were also present. A new RT-PCR test from nasopharyngeal swabs was performed with a positive result. Our two patients described here and other patients with possible reinfection who are now being observed in clinical practice reinforce the need to expand the investigation. Then, if the risk of reinfection is confirmed, these findings will be relevant from a clinical-epidemiological perspective to define isolation strategies and develop vaccines.
虽然在动物模型中已证明初次感染可预防严重急性呼吸综合征冠状病毒2（SARS-CoV-2）再次感染，但对该病毒免疫反应的认识差距尚未得到充分解决，并且已报告了一些可能再次感染的病例；然而，这些事件的频率、相关性和证据仍有待确定。我们报告了两名医生的病例，他们两次出现COVID-19且逆转录酶聚合酶链反应（RT-PCR）检测结果呈阳性，这增加了再次感染的可能性。病例1是一名40岁男性医生，4月10日出现发热和呼吸道症状，SARS-CoV-2的RT-PCR检测呈阳性，症状在五天内完全改善。44天后，患者出现与前次发作相同的症状，并伴有嗅觉丧失和味觉障碍。两天后进行的新RT-PCR检测结果显示SARS-CoV-2呈阳性。病例2是一名44岁女性医生，在一家COVID-19（2019冠状病毒病）参考诊所工作，4月30日出现该疾病的症状。SARS-CoV-2的RT-PCR检测呈阳性，症状在六天内有所改善。5月24日，患者出现发热、咳嗽、咽痛，并伴有头痛、乏力、肌痛和腹泻，在这次新发作中，也出现了嗅觉丧失和味觉障碍。对鼻咽拭子进行的新RT-PCR检测结果呈阳性。我们在此描述的两名患者以及目前在临床实践中正在观察的其他可能再次感染的患者，进一步强调了扩大调查的必要性。那么，如果再次感染的风险得到证实，这些发现将从临床流行病学角度对定义隔离策略和研发疫苗具有重要意义。
