Dados do Trabalho

Título

SARS-CoV-2 reinfection: A series of reinfection cases from Brazil documented by the genomic features of first and second infecting strains

Introdução

Reinfection cases of Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) have been reported globally. These events have become more frequent since the emergence of the variants of concern (VOCs) in the last quarter of 2020. The first case of reinfection indentified in Brazil and reported was described - in December 2020.

Objetivo (s)

In this study, we evaluated a series reinfection cases in Brazil from 2020 to 2022.

Material e Métodos

SARS-COV-2 was detected in two samples of COVID-19 cases collected at least 90 days apart. Up to 386 reinfection suspected cases from different Brazilian regions (North, Northeast, South, and Southeast) were evaluated and case confirmation was performed by real time RT-PCR followed by whole genome sequencing. SARS-CoV-2 lineages were characterized, and the presence of minor variants characterized using the Viralflow.

Resultados e Conclusão

A total of 65 reinfection cases were confirmed and all cases had satisfactory clinical outcomes. The lineages responsible for the first infection in these cases were: B.1.1.33, B.1.1.28, and P.2 in 2020 (30 cases) and P.1, P.2, B.1.1.7, N.9, AY.99.2, and AY.101 in 2021 (35 cases). In these cases, the second SARS-CoV-2 infection was caused mainly by the variant of interest (VOI) P.2 (2 cases) or variant of concern (VOC) Gamma/P.1/P.1* (9 cases), Delta/AY*/B.1.617.2 (5 cases), and Omicron/BA* (47 cases). The VOC Omicron was predominant in reinfection cases (72,3%, 47/65), caused by different lineages BA.1. * and BA.2. In these confirmed reinfection cases, 7.7% occurred prior complete vaccination course.Intra-host analysis of SARS-CoV-2 genomes from the first and second infections showed that 90% (39/43 cases analyzed) had minor variants, mostly present in R2 (second infection).The VOC Omicron in relation to other VOCs presents a greater number of mutations, important mutations in the Spike (S) protein and in the ORF1A region, responsible for evading neutralization and increasing the chances of cases of reinfection. Our findings reinforce that previous natural infection does not prevent new infections in the cases evaluated. We reinforce the role of VOCs since their emergence that all reported reinfections have been present.

Palavras-chave

Reinfecction; Reinfecction cases; SARS-CoV-2 reinfecction