Proper Assignation of Reactivation in a COVID-19 Recurrence Initially Interpreted as a Reinfection

J Infect Dis. 2021 Sep 1;224(5):788-792. doi: 10.1093/infdis/jiab302.

Abstract

A 77-year-old man (case R) with previous diagnosis of a mild COVID-19 episode was hospitalized 35 days later. On day 23 postadmission, he developed a second COVID-19 episode, now severe, and finally died. Initially, case R's COVID-19 recurrence was interpreted as a reinfection due to the exposure to a SARS-CoV-2 RT-PCR-positive roommate. However, whole-genome sequencing indicated that case R's recurrence corresponded to a reactivation of the strain involved in his first episode. Case R's reactivation had major consequences, leading to a more severe episode, and causing subsequent transmission to another 2 hospitalized patients, 1 of them with fatal outcome.

Keywords: COVID-19; SARS-CoV-2; WGS; nosocomial transmission; reactivation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antibodies, Viral / immunology
  • COVID-19 / diagnosis*
  • COVID-19 / immunology
  • COVID-19 / virology
  • Humans
  • Male
  • Recurrence
  • Reinfection / diagnosis*
  • Reinfection / immunology
  • Reinfection / virology*
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / immunology
  • Whole Genome Sequencing / methods

Substances

  • Antibodies, Viral