Genomic evidence for reinfection with SARS-CoV-2: a case study

Type Journal Article Author Richard L. Tillett Author Joel R. Sevinsky Author Paul D. Hartley Author Heather Kerwin Author Natalie Crawford Author Andrew Gorzalski Author Chris Laverdure Author Subhash C. Verma Author Cyprian C. Rossetto Author David Jackson Author Megan J. Farrell Author Stephanie Van Hooser Author Mark Pandori URL https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30764-7/abstract Publication The Lancet Infectious Diseases ISSN 1473-3099, 1474-4457 Date 12/10/2020 Extra Publisher: Elsevier PMID: 33058797 Journal Abbr The Lancet Infectious Diseases DOI 10.1016/S1473-3099(20)30764-7 Library Catalog www.thelancet.com Language English Abstract Background The degree of protective immunity conferred by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently unknown. As such, the possibility of reinfection with SARS-CoV-2 is not well understood. We describe an investigation of two instances of SARS-CoV-2 infection in the same individual. Methods A 25-year-old man who was a resident of Washoe County in the US state of Nevada presented to health authorities on two occasions with symptoms of viral infection, once at a community testing event in April, 2020, and a second time to primary care then hospital at the end of May and beginning of June, 2020. Nasopharyngeal swabs were obtained from the patient at each presentation and twice during follow-up. Nucleic acid amplification testing was done to confirm SARS-CoV-2 infection. We did next-generation sequencing of SARS-CoV-2 extracted from nasopharyngeal swabs. Sequence data were assessed by two different bioinformatic methodologies. A short tandem repeat marker was used for fragment analysis to confirm that samples from both infections came from the same individual. Findings The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first. Short Title Genomic evidence for reinfection with SARS-CoV-2