Loconsole Daniela, Sallustio Anna, Accogli Marisa, Centrone Francesca, Casulli Daniele, Madaro Antonino, Tedeschi Ersilia, Parisi Antonio, Chironna Maria
Department of Biomedical Sciences and Human Oncology-Hygiene Section, University of Bari, 70124 Bari, Italy.
Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy.
Viruses. 2021 May 12;13(5):899. doi: 10.3390/v13050899.
This study describes a case of SARS-CoV-2 reinfection confirmed by whole-genome sequencing in a healthy physician who had been working in a COVID-19 hospital in Italy since the beginning of the pandemic. Nasopharyngeal swabs were obtained from the patient at each presentation as part of routine surveillance. Nucleic acid amplification testing was performed on the two samples to confirm SARS-CoV-2 infection, and serological tests were used to detect SARS-CoV-2 IgG antibodies. Comparative genome analysis with whole-genome sequencing was performed on nasopharyngeal swabs collected during the two episodes of COVID-19. The first COVID-19 episode was in March 2020, and the second was in January 2021. Both SARS-CoV-2 infections presented with mild symptoms, and seroconversion for SARS-CoV-2 IgG was documented. Genomic analysis showed that the viral genome from the first infection belonged to the lineage B.1.1.74, while that from the second infection to the lineage B.1.177. Epidemiological, clinical, serological, and genomic analyses confirmed that the second episode of SARS-CoV-2 infection in the healthcare worker met the qualifications for "best evidence" for reinfection. Further studies are urgently needed to assess the frequency of such a worrisome occurrence, particularly in the light of the recent diffusion of SARS-CoV-2 variants of concern.
本研究描述了一例新型冠状病毒（SARS-CoV-2）再次感染病例，该病例通过全基因组测序得以确诊。患者是一名健康的医生，自疫情开始以来一直在意大利一家新冠肺炎医院工作。作为常规监测的一部分，每次就诊时都从患者处采集鼻咽拭子。对两份样本进行核酸扩增检测以确认SARS-CoV-2感染，并使用血清学检测来检测SARS-CoV-2 IgG抗体。对两次新冠肺炎发作期间采集的鼻咽拭子进行了全基因组测序的比较基因组分析。第一次新冠肺炎发作发生在2020年3月，第二次发生在2021年1月。两次SARS-CoV-2感染均表现为轻微症状，且记录到了SARS-CoV-2 IgG的血清转化。基因组分析表明，第一次感染的病毒基因组属于B.1.1.74谱系，而第二次感染的病毒基因组属于B.1.177谱系。流行病学、临床、血清学和基因组分析证实，该医护人员第二次SARS-CoV-2感染符合再次感染“最佳证据”的标准。迫切需要进一步研究来评估这种令人担忧的情况的发生频率，尤其是鉴于最近值得关注的SARS-CoV-2变异株的传播。
