Borras-Bermejo Blanca, Piñana Maria, Andrés Cristina, Zules Ricardo, González-Sánchez Alejandra, Esperalba Juliana, Parés-Badell Oleguer, García-Cehic Damir, Rando Ariadna, Campos Carolina, Codina Maria Gema, Martín Maria Carmen, Castillo Carla, García-Comuñas Karen, Vásquez-Mercado Rodrigo, Martins-Martins Reginald, Colomer-Castell Sergi, Pumarola Tomàs, Campins Magda, Quer Josep, Antón Andrés
Department of Preventive Medicine and Epidemiology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain.
Respiratory Viruses Unit, Virology Section, Microbiology Department, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Vall d'Hebron Hospital Universitari, Barcelona, Spain.
Front Microbiol. 2022 May 26;13:876409. doi: 10.3389/fmicb.2022.876409. eCollection 2022.
Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the main concern is whether reinfections are possible, and which are the associated risk factors. This study aims to describe the clinical and molecular characteristics of 24 sequence-confirmed reinfection SARS-CoV-2 cases over 1 year in Barcelona (Catalonia, Spain).
Patients with > 45 days between two positive PCR tests regardless of symptoms and negative tests between episodes were initially considered as suspected reinfection cases from November 2020 to May 2021. Whole-genome sequencing (WGS) was performed to confirm genetic differences between consensus sequences and for phylogenetic studies based on PANGOLIN nomenclature. Reinfections were confirmed by the number of mutations, change in lineage, or epidemiological criteria.
From 39 reported suspected reinfection cases, complete viral genomes could be sequenced from both episodes of 24 patients, all were confirmed as true reinfections. With a median age of 44 years (interquartile range [IQR] 32-65), 66% were women and 58% were healthcare workers (HCWs). The median days between episodes were 122 (IQR 72-199), occurring one-third within 3 months. Reinfection episodes were frequently asymptomatic and less severe than primary infections. The absence of seroconversion was associated with symptomatic reinfections. Only one case was reinfected with a variant of concern (VOC).
Severe acute respiratory syndrome coronavirus 2 reinfections can occur in a shorter time than previously reported and are mainly found in immunocompetent patients. Surveillance through WGS is useful to identify viral mutations associated with immune evasion.
自严重急性呼吸综合征冠状病毒2（SARS-CoV-2）出现以来，主要关注的问题是是否可能再次感染以及相关的风险因素有哪些。本研究旨在描述西班牙加泰罗尼亚巴塞罗那24例经序列确认的1年内再次感染SARS-CoV-2病例的临床和分子特征。
2020年11月至2021年5月期间，最初将两次PCR检测呈阳性间隔超过45天且期间检测为阴性的患者视为疑似再次感染病例，无论其有无症状。进行全基因组测序（WGS）以确认共有序列之间的遗传差异，并基于穿山甲命名法进行系统发育研究。通过突变数量、谱系变化或流行病学标准来确认再次感染。
在39例报告的疑似再次感染病例中，可对24例患者两次发作时的病毒基因组进行完整测序，所有病例均被确认为真正的再次感染。患者中位年龄为44岁（四分位间距[IQR]32 - 65），66%为女性，58%为医护人员（HCW）。两次发作之间的中位天数为122天（IQR 72 - 199），三分之一发生在3个月内。再次感染发作通常无症状，且比初次感染症状轻。血清转化未出现与有症状的再次感染相关。仅1例患者再次感染了变异株（VOC）。
严重急性呼吸综合征冠状病毒2再次感染可在比先前报告更短的时间内发生，且主要见于免疫功能正常的患者。通过WGS进行监测有助于识别与免疫逃逸相关的病毒突变。
