This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Darío García de Viedma
Gregorio Marañón General University Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- This study is a case report.
- The author has confirmed that consent for publication of clinical details and/or clinical images was obtained from the patient/parent/guardian/relative of the patient or waiver of such consent is described in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
Rationale: The first descriptions of reinfection by SARS-CoV-2 have been recently reported. However, these studies focus exclusively on the reinfected case, without considering the epidemiological context of the event.
Objectives: To perform a complete analysis of the sequential infections and transmission events around a SARS-CoV-2 reinfection, including the infection events preceding it, the exposure and subsequent transmissions.
Methods: Our analysis was supported by host genetics, viral whole genome sequencing, phylogenomic viral population analysis, and refined epidemiological data obtained from interviews with the involved subjects.
Results: The reinfection involved a 53-year-old woman with asthma (Case A), with a first COVID-19 episode in April-2020 and a much more severe second episode four months and a half later, with COVID-19 seroconversion in August, and requiring hospital admission. An extended genomic analysis allowed us to demonstrate that the strain involved in Case A´s reinfection was circulating in the epidemiological context of Case A and was also transmitted subsequently from Case A to her family context. The reinfection was also supported by a phylogenetic analysis, including 348 strains from Madrid, which revealed that the strain involved in the reinfection was circulating by the time Case A suffered the second episode, August/September-2020, but absent at the time range corresponding to Case A´s first episode.
Conclusion: We present the first complete analysis of the epidemiological scenario around a reinfection by SARS-CoV-2, more severe than the first episode, including three cases preceding the reinfection, the reinfected case per se, and the subsequent transmission to another seven cases.
Keywords
COVID-19, reinfection, transmission, epidemiology, genomics
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- SupplFig1upload.pdf
Supplementary Figure 1: Microsatellite STR-PCR analysis on the patient A specimens to confirm the same origin of the samples.
- SpplFig2upload.pdf
Supplementary Figure 2: Dated phylogeny of the strains closely related to that found in the second episode of case A. The strain of the case A is marked with a black arrow. The strain belongs to a phylogenetic clade that was not circulating before June 2020 and thus excluding that the strain belongs to the first wave.
- SupplTable.docx
Supplementary Table
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Darío García de Viedma
Gregorio Marañón General University Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
The most recent version of this article is available here.
Community comments: 1
Version 1
Posted 13 Nov, 2020
No comments provided
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Declarations:
Declarations
- This study involved human subjects.
- The author confirmed that all appropriate ethical guidelines for the use of human subjects have been followed, any necessary IRB and/or ethics committee review has been obtained, and information about the IRB/ethics committee is included in the manuscript.
- The author has confirmed that all necessary patient/participant consent or assent has been obtained and the appropriate institutional forms have been archived. If the IRB/ethics committee waived the requirement for patient/participant consent or assent, an explanation for the waiver is included in the text.
- This study is a case report.
- The author has confirmed that consent for publication of clinical details and/or clinical images was obtained from the patient/parent/guardian/relative of the patient or waiver of such consent is described in the text.
- The author has confirmed that a statement listing potential conflicts of interest or lack thereof is included in the text.
The most recent version of this article is available here.
Rationale: The first descriptions of reinfection by SARS-CoV-2 have been recently reported. However, these studies focus exclusively on the reinfected case, without considering the epidemiological context of the event.
Objectives: To perform a complete analysis of the sequential infections and transmission events around a SARS-CoV-2 reinfection, including the infection events preceding it, the exposure and subsequent transmissions.
Methods: Our analysis was supported by host genetics, viral whole genome sequencing, phylogenomic viral population analysis, and refined epidemiological data obtained from interviews with the involved subjects.
Results: The reinfection involved a 53-year-old woman with asthma (Case A), with a first COVID-19 episode in April-2020 and a much more severe second episode four months and a half later, with COVID-19 seroconversion in August, and requiring hospital admission. An extended genomic analysis allowed us to demonstrate that the strain involved in Case A´s reinfection was circulating in the epidemiological context of Case A and was also transmitted subsequently from Case A to her family context. The reinfection was also supported by a phylogenetic analysis, including 348 strains from Madrid, which revealed that the strain involved in the reinfection was circulating by the time Case A suffered the second episode, August/September-2020, but absent at the time range corresponding to Case A´s first episode.
Conclusion: We present the first complete analysis of the epidemiological scenario around a reinfection by SARS-CoV-2, more severe than the first episode, including three cases preceding the reinfection, the reinfected case per se, and the subsequent transmission to another seven cases.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- SupplFig1upload.pdf
Supplementary Figure 1: Microsatellite STR-PCR analysis on the patient A specimens to confirm the same origin of the samples.
- SpplFig2upload.pdf
Supplementary Figure 2: Dated phylogeny of the strains closely related to that found in the second episode of case A. The strain of the case A is marked with a black arrow. The strain belongs to a phylogenetic clade that was not circulating before June 2020 and thus excluding that the strain belongs to the first wave.
- SupplTable.docx
Supplementary Table
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