Critical Presentation of a Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection : A Case Report
Massanella, Marta (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Martin-Urda, Anabel (Hospital de Palamós)
Mateu, Lourdes (Universitat Autònoma de Barcelona. Departament de Medicina)
Marín, Toni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Aldas Criado, Irene (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Riveira Muñoz, Eva (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Kipelainen, Athina (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Jiménez-Moyano, Esther (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Rodriguez de la Concepción, Maria Luisa (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Avila-Nieto, Carlos (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Trinité, Benjamin (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Pradenas, Edwards (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Rodon, Jordi (Institut de Recerca i Tecnologia Agroalimentàries. Centre de Recerca en Sanitat Animal)
Marfil, Sílvia (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Parera, Mariona (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Carrillo, Jorge (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Blanco, Julià (Universitat de Vic - Universitat Central de Catalunya)
Prado, Julia G.. (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Ballana, Ester (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Vergara-Alert, Júlia (Institut de Recerca i Tecnologia Agroalimentàries. Centre de Recerca en Sanitat Animal)
Segalés Coma, Joaquim (Universitat Autònoma de Barcelona. Departament de Sanitat i d'Anatomia Animals)
Noguera-Julian, Marc (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Masabeu, Àngels (Hospital de Palamós)
Clotet Sala, Bonaventura (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Toda, Maria de la Roca (Hospital de Palamós)
Paredes, Roger (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2021
Abstract:	Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections have been reported; however, most cases are milder than the primary infection. We report the first case of a life-threatening critical presentation of a SARS-CoV-2 reinfection. A 62-year-old man from Palamós (Spain) suffered a first mild coronavirus disease 2019 (COVID-19) episode in March 2020, confirmed by 2 independent SARS-CoV-2 nasopharyngeal polymerase chain reaction (PCR) assays and a normal radiograph. He recovered completely and tested negative on 2 consecutive PCRs. In August 2020, the patient developed a second SARS-CoV-2 infection with life-threatening bilateral pneumonia and Acute respiratory distress syndrome criteria, requiring COVID-19-specific treatment (remdesivir + dexamethasone) plus high-flow oxygen therapy. Nasopharyngeal swabs from the second episode were obtained for virus quantification by real-time PCR, for virus outgrowth and sequencing. In addition, plasma and peripheral blood mononuclear cells during the hospitalization period were used to determine SARS-CoV-2-specific humoral and T-cell responses. Genomic analysis of SARS-CoV-2 showed that the virus had probably originated shortly before symptom onset. When the reinfection occurred, the subject showed a weak immune response, with marginal humoral and specific T-cell responses against SARS-CoV-2. All antibody isotypes tested as well as SARS-CoV-2 neutralizing antibodies increased sharply after day 8 postsymptoms. A slight increase of T-cell responses was observed at day 19 after symptom onset. The reinfection was firmly documented and occurred in the absence of robust preexisting humoral and cellular immunity. SARS-CoV-2 immunity in some subjects is unprotective and/or short-lived; therefore, SARS-CoV-2 vaccine schedules inducing long-term immunity will be required to bring the pandemic under control.
Grants:	Instituto de Salud Carlos III PI17/01518 Instituto de Salud Carlos III PI18/01332
Note:	Altres ajuts: Departament de Salut de la Generalitat de Catalunya (DSL0016), (DSL015)
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Immune responses ; Life threatening COVID-19 ; Reinfection ; SARS-CoV-2 ; Secondary infection
Published in:	Open Forum Infectious Diseases, Vol. 8 (june 2021) , ISSN 2328-8957

DOI: 10.1093/ofid/ofab329
PMID: 34337095

6 p, 306.3 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles