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Late reinfection with a different severe acute respiratory syndrome coronavirus-2 clade in a patient with refractory arterial hypertension: a case report.
J Med Case Rep. 2021 Sep 06; 15(1):454.JM

Abstract

BACKGROUND

Differentiating between persistent infection with intermittent viral shedding and reinfection with severe acute respiratory syndrome coronavirus 2 remains challenging. Although a small number of cases with genomic evidence of second infection have been reported, limited information exists on frequency and determinants of reinfection, time between infections, and duration of immunity after the primary infection.

CASE PRESENTATION

We report a reinfection with severe acute respiratory syndrome coronavirus 2 in a 52-year-old caucasian male whose primary infection was diagnosed in May 2020, during the first wave of the pandemic in Spain, and the second occurred 8 months later, in January 2021. We present a complete dataset including results from real-time polymerase chain reaction, serology, and genome sequencing confirming reinfection with a different clade. Noteworthy was that the patient was immunocompetent but had multiple cardiometabolic comorbidities, including refractory arterial hypertension, that might increase the individual risk in coronavirus disease 2019.

CONCLUSIONS

This case of reinfection with severe acute respiratory syndrome coronavirus 2 occurring several months after the primary infection reports the longest time interval between reinfection and initial infection described to date. It raises concerns on the duration of protective immunity, suggesting that it may begin to wane in patients who acquired the initial infection during the first wave of the pandemic. The potential contributing role of arterial hypertension and cardiometabolic comorbidities as risk factors for reinfection deserves investigation.

Authors+Show Affiliations

Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Microbiology Service, Hospital General de Elche, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Microbiology Service, Hospital General de Elche, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Microbiology Service, Hospital General de Elche, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain.Infectious Diseases Unit, Hospital General de Elche and Universidad Miguel Hernández, Camino de la Almazara 11, 03203, Elche, Alicante, Spain. gutierrez_fel@gva.es.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

34488872

Citation

García-Abellán, Javier, et al. "Late Reinfection With a Different Severe Acute Respiratory Syndrome Coronavirus-2 Clade in a Patient With Refractory Arterial Hypertension: a Case Report." Journal of Medical Case Reports, vol. 15, no. 1, 2021, p. 454.
García-Abellán J, Galiana A, Fernández-González M, et al. Late reinfection with a different severe acute respiratory syndrome coronavirus-2 clade in a patient with refractory arterial hypertension: a case report. J Med Case Rep. 2021;15(1):454.
García-Abellán, J., Galiana, A., Fernández-González, M., Gonzalo-Jiménez, N., Ruiz-García, M., Botella, A., Sanchis, J., Mascarell, P., Falcón, S., Masiá, M., & Gutiérrez, F. (2021). Late reinfection with a different severe acute respiratory syndrome coronavirus-2 clade in a patient with refractory arterial hypertension: a case report. Journal of Medical Case Reports, 15(1), 454. https://doi.org/10.1186/s13256-021-03071-2
García-Abellán J, et al. Late Reinfection With a Different Severe Acute Respiratory Syndrome Coronavirus-2 Clade in a Patient With Refractory Arterial Hypertension: a Case Report. J Med Case Rep. 2021 Sep 6;15(1):454. PubMed PMID: 34488872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late reinfection with a different severe acute respiratory syndrome coronavirus-2 clade in a patient with refractory arterial hypertension: a case report. AU - García-Abellán,Javier, AU - Galiana,Antonio, AU - Fernández-González,Marta, AU - Gonzalo-Jiménez,Nieves, AU - Ruiz-García,Montserrat, AU - Botella,Angela, AU - Sanchis,Joan, AU - Mascarell,Paula, AU - Falcón,Selene, AU - Masiá,Mar, AU - Gutiérrez,Félix, Y1 - 2021/09/06/ PY - 2021/06/14/received PY - 2021/08/23/accepted PY - 2021/9/7/entrez PY - 2021/9/8/pubmed PY - 2021/9/9/medline KW - Antibody response KW - COVID-19 KW - Case report KW - Reinfection KW - SARS-CoV-2 SP - 454 EP - 454 JF - Journal of medical case reports JO - J Med Case Rep VL - 15 IS - 1 N2 - BACKGROUND: Differentiating between persistent infection with intermittent viral shedding and reinfection with severe acute respiratory syndrome coronavirus 2 remains challenging. Although a small number of cases with genomic evidence of second infection have been reported, limited information exists on frequency and determinants of reinfection, time between infections, and duration of immunity after the primary infection. CASE PRESENTATION: We report a reinfection with severe acute respiratory syndrome coronavirus 2 in a 52-year-old caucasian male whose primary infection was diagnosed in May 2020, during the first wave of the pandemic in Spain, and the second occurred 8 months later, in January 2021. We present a complete dataset including results from real-time polymerase chain reaction, serology, and genome sequencing confirming reinfection with a different clade. Noteworthy was that the patient was immunocompetent but had multiple cardiometabolic comorbidities, including refractory arterial hypertension, that might increase the individual risk in coronavirus disease 2019. CONCLUSIONS: This case of reinfection with severe acute respiratory syndrome coronavirus 2 occurring several months after the primary infection reports the longest time interval between reinfection and initial infection described to date. It raises concerns on the duration of protective immunity, suggesting that it may begin to wane in patients who acquired the initial infection during the first wave of the pandemic. The potential contributing role of arterial hypertension and cardiometabolic comorbidities as risk factors for reinfection deserves investigation. SN - 1752-1947 UR - https://www.unboundmedicine.com/medline/citation/34488872/Late_reinfection_with_a_different_severe_acute_respiratory_syndrome_coronavirus_2_clade_in_a_patient_with_refractory_arterial_hypertension:_a_case_report_ L2 - https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-03071-2 DB - PRIME DP - Unbound Medicine ER -