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

Anna Gidari; Marco Nofri; Luca Saccarelli; Sabrina Bastianelli; Samuele Sabbatini; Silvia Bozza; Barbara Camilloni; Igino Fusco Moffa; Claudia Monari; Edoardo De Robertis; Antonella Mencacci

Ayuda

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

Anna Gidari ^[1] ; Marco Nofri ^[1] ; Luca Saccarelli ^[1] ; Sabrina Bastianelli ^[1] ; Samuele Sabbatini ^[1] ; Silvia Bozza ^[1] ; Barbara Camilloni ^[1] ; Igino Fusco-Moffa ^[2] ; Claudia Monari ^[1] ; Edoardo De Robertis ^[1] ; Antonella Mencacci ^[1]
1. [1] Università di Perugia
  
  Università di Perugia
  
  Perusa, Italia
2. [2] Department of Prevention, Local Health Unit Umbria 1, Travel Medicine Unit, Perugia, Italy
Localización: Vitae: Academia Biomédica Digital, ISSN-e 1317-987X, Nº. 82, 2020 (Ejemplar dedicado a: Edición especial COVID-19)
Idioma: inglés
Enlaces
- Texto completo (pdf)
Resumen
- 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.