Edición especial COVID-19 Abril-Diciembre 2020 82
ISSN 1317-987X
 
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Actualidad COVID-19
Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature
Fecha de recepción: 24/07/2020
Fecha de aceptación:
30/09/2020




Abstract

Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved. We tried to analyze local and literature cases with a positive respiratory swab after recovery. We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens. Samples were also assessed for infectivity in vitro. A systematic review of similar cases reported in the literature was performed. The study population was composed of 9 patients during a 4-month study period. Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants. All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein. Conducting a review of the literature, 1350 similar cases have been found. The presumptive reactivation occurred in 34.5 days on average (standard deviation, SD, 18.7 days) after COVID-19 onset, when the 5.6% of patients presented fever and the 27.6% symptoms. The outcome was favorable in 96.7% of patients, while the 1.1% of them were still hospitalized at the time of data collection and the 2.1% died. Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity. According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients. The failure of the virus to replicate in vitro suggests its inability to replicate in vivo.



Key Word
COVID-19 . SARS-CoV-2 . Recurrence . Reactivation . Re-infection

Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature

Anna Gidari1, Marco Nofri1, Luca Saccarelli2, Sabrina Bastianelli1, Samuele Sabbatini3, Silvia Bozza3, Barbara Camilloni3, Igino Fusco-Moffa4, Claudia Monari3, Edoardo De Robertis2, Antonella Mencacci3, Daniela Francisci

Anna Gidari and Marco Nofri contributed equally to this work.

* Anna Gidarianna.gidari@studenti.unipg.it

1 Department ofMedicine, Clinic of Infectious Diseases, “SantaMariadella Misericordia” Hospital, University of Perugia, Perugia, Italy

2 Department of Anesthesiology, Intensive Care and Pain therapyCenter, Santa Maria della MisericordiaHospital, University ofPerugia, Perugia, Italy

3 Department of Medicine, Medical Microbiology Section, Universityof Perugia, Perugia, Italy

4 Department of Prevention, Local Health Unit Umbria 1, TravelMedicine Unit, Perugia, Italy

European Journal of Clinical Microbiology & Infectious Diseases

Volume 39, issue 10, October 2020



Is recurrence possible in coronavirus disease 2019 (COVID-19)? Case series and systematic review of literature

NOTA: Toda la información que se brinda en este artículo es de carácter investigativo y con fines académicos y de actualización para estudiantes y profesionales de la salud. En ningún caso es de carácter general ni sustituye el asesoramiento de un médico. Ante cualquier duda que pueda tener sobre su estado de salud, consulte con su médico o especialista.





Instituto de Medicina Tropical - Facultad de Medicina - Universidad Central de Venezuela.
Elaborado por el Centro de Análisis de Imágenes Biomédicas Computarizadas CAIBCO,
caibco@ucv.ve
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