Evaluation of the presence of reinfection in patients presenting to the emergency department with COVID-19 symptoms after recovery

This study aimed to evaluate COVID-19 reinfection in patients that presented to the emergency department with similar or different COVID-19 symptoms after recovery from the disease. This retrospective study included patients aged over 18 years presenting to the emergency department between January 1, 2021 and July 1, 2021, who had been previously diagnosed with COVID-19 and received treatment for the disease. Statistical analysis was performed using SPSS version 22.0.A total of 199 patients, 54.3% female, were included in the study. PCR positivity was present in 2.5% of the patients, and it was statistically significantly low(p<0.001). The most common symptom was fatigue (46.2%), and the least common symptom was loss of taste (3.0%). However, there was a statistically significant correlation between the loss of taste and smell and PCR positivity (p=0.024 and p=0.043, respectively). The logistic regression analysis revealed that the loss of taste and loss of smell alone did not have an effect on PCR positivity (p=0.848, 95% confidence interval: 0.005-71.83 and p=0.287, 95% confidence interval: 0.001-9.369). In the Covid-19 management and treatment guide, it is necessary to make changes in terms of symptoms for people who have had Covid-19 disease. Copyright © 2022 Ondokuz Mayis Universitesi. All rights reserved.

Avidity of IgG to SARS-CoV-2 RBD as a Prognostic Factor for the Severity of COVID-19 Reinfection.

The avidity index (AI) of IgG to the RBD of SARS-CoV-2 was determined for 71 patients with a mild (outpatient) course of COVID-19, including 39 primarily and 36 secondarily reinfected, and 92 patients with a severe (hospital) course of COVID-19, including 82 primarily and 10 secondarily infected. The AI was shown to correlate with the severity of repeated disease. In the group of outpatients with a mild course, the reinfected patients had significantly higher median AIs than those with primary infections (82.3% vs. 37.1%, p < 0.0001). At the same time, in patients with a severe course of COVID-19, reinfected patients still had low-avidity antibodies (median AI of 28.4% vs. 25% in the primarily infected, difference not significant, p > 0.05). This suggests that the presence of low-avidity IgG to RBD during reinfection is a negative prognostic factor, in which a patient's risk of developing COVID-19 in a severe form is significantly increased. Thus, patients with IgG of low avidity (AI ≤ 40%) had an 89 ± 20.5% chance of a severe course of recurrent COVID-19, whereas the detection of high-avidity antibodies (AI ≥ 50%) gave a probability of 94 ± 7.9% for a mild course of recurrent disease (p < 0.05).

Symptomatic COVID-19 Reinfection with Pericardial and Pleural Involvement.

Coronavirus disease 2019 (COVID-19) is a contagious acute respiratory tract infection caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2), a beta coronavirus first discovered in Wuhan, China in late 2019. COVID-19 is spreading rapidly globally and has been officially declared a pandemic by the World Health Organization (WHO) as of March 2020. Most recent studies suggest that immunity can develop after an episode of severe acute respiratory syndrome Infections. There are few cases with severe symptomatic reinfection. Here we present the case of a healthy 46-year-old man with pericardial-pleural and lung involvement in the setting of COVID-19 infection first, and severe symptomatic reinfection thereafter.

Major Spinal Surgery Between Two Documented COVID-19 Infections in an Elderly Female: A Case Report.

Documented re-infection of COVID-19 is uncommon and doing a major spinal surgery in an elderly patient right after the recovery from the first event is itself a major undertaking. Re-infection after successful surgery points to the possibility of COVID-19 infection being a post-surgical complication. Here, we report a case of a 72-years-old elderly female who had presented to us with features of COVID-19 infection confirmed by reverse transcription polymerase chain reaction assay and unstable spinal fracture who underwent a pedicle screw fixation for the fracture of the third and fourth thoracic vertebrae after two consecutive negative serology assays. A month after discharge from the hospital, she presented with severe symptoms of COVID-19 again confirmed by two consecutive polymerase chain reaction assays. She was managed conservatively and was discharged without significant respiratory and neurological complications. We described this case in detail in addition to reviewing the pertinent literature.

Low risk of reinfections and relation with serological response after recovery from the first wave of COVID-19.

The aim of the study was to assess reinfection rates in relation to long-term antibody dynamics against SARS-CoV-2 after the first wave. A prospective longitudinal study with monthly serological follow-up during the first 4 months, and then at 6, 8, and 10 months after the disease onset of all recovered adult in- and outpatients with COVID-19 attending Udine Hospital (Italy) from March to May 2020. During the follow-up, reinfections were collected. A total of 546 unselected individuals with COVID-19 acquired from March to May 2020 were included (292 female, mean age 53 years). After a median follow-up of 10 months (IQR 6.2-10.4), reinfection occurred in 6 (1.1%) patients, median age of 44.5 years (IQR 33‒49). All had a previous history of mild COVID-19 (all were healthcare workers) and reinfection occurred a median of 9 months (IQR 8.2‒10.2) after the onset of the first episode. Patients with reinfection were either seronegative (2/56, n = 3.6%), seroreverted (2/137, 1.5%), or seropositive (2/353, 0.6%) (p = 0.085). All reinfections were mild (n = 5) or asymptomatic (n = 1). After reinfection, none of patients developed IgM response and only two had a transitory boosted IgG immunization response. In an unselected population after the first wave of COVID-19, after a prolonged observation period (mean 10 months), reinfection was very uncommon; occurred in patients with a previous history of mild infection, mostly with weak or absent serological response; and manifested with mild or asymptomatic clinical presentation.

Re-Positive SARS-CoV-2 With Respiratory Failure and Cerebrovascular Accident: Is This a Reinfection?

The coronavirus disease 2019 ( COVID-19) pandemic is a global pandemic where healthcare providers are concerned about the reinfection of recovered patients. The reinfection with COVID-19 is not common and considered less likely, but as time passes by, there are reports of patients becoming positive after having tested negative previously. Here, we report a case of a 28-year-old male with diabetes mellitus type 1, hypertension, and end-stage renal disease on hemodialysis who presented initially in April 2020 with nausea, vomiting, and dyspnea. His severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) came back positive. He left against medical advice but was followed as an outpatient in the dialysis unit where he continued with dialysis in isolation for positive COVID-19 as per the dialysis unit guidelines. He presented three months later with altered level of consciousness in the setting of diabetic ketoacidosis. He also had gastrointestinal bleed and cerebrovascular accident. There was a strong possibility of reinfection in this patient as he was tested negative after the initial infection and then tested positive three months later, presenting with a different set of symptoms and more severe disease on his second admission.

SARS-CoV-2 reinfection: "New baseline" imaging concept in the era of COVID-19.

Recent reports have suggested COVID-19 relapse or reinfection may lead to readmission, which may cause a diagnostic challenge between recently infected patients and reinfections. Compounding this problem is the post-viral lung sequela that may be expected after COVID-19 pneumonia, similar to both SARS and MERS. Although chest imaging may play a role in the diagnosis of primary SARS-CoV-2 infection, reinfection or relapse of COVID-19 will have similar imaging findings. A "new-baseline" imaging can be obtained from COVID-19 patients at the time of hospital discharge or clinical recovery. This new reference can not only determine if readmissions are from relapse or reinfection of COVID-19, resolving COVID-19 or potentially a different viral infection (influenza), but also for long term sequela of COVID-19 lung infection. Strategic use of imaging before discharge may be helpful in the subset of the population at the highest risk of a secondary viral infection such as influenza. Determining the residual abnormalities in post-discharge imaging can guide us in the long-term management of patients for many years to come.

COVID-19 Reinfection.

The possibilities of coronavirus disease 2019 (COVID-19) to reinfect individuals have not been reported yet. All reported hypothesis of reinfection has been attributed to either relapse of the disease or having a mild course of symptoms. We report two cases of COVID-19 positive patients where they had complete resolution of symptoms and negative COVID-19 results. Weeks later, they returned with milder symptoms and a positive COVID-19 culture swab. In conclusion, early stages of COVID-19 where mild signs and symptoms are reported can be prolonged and the virus can stay dormant in the body for relapse later on.

Impact of reproduction number on the multiwave spreading dynamics of COVID-19 with temporary immunity: A mathematical model.

OBJECTIVES: The recent discoveries of phylogenetically confirmed COVID-19 reinfection cases worldwide, together with studies suggesting that antibody titres decrease over time, raise the question of what course the epidemic trajectories may take if immunity were really to be temporary in a significant fraction of the population. The objective of this study is to obtain an answer for this important question. METHODS: We construct a ground-up delay differential equation model tailored to incorporate different types of immune response. We considered two immune responses: (a) short-lived immunity of all types, and (b) short-lived sterilizing immunity with durable severity-reducing immunity. RESULTS: Multiple wave solutions to the model are manifest for intermediate values of the reproduction number R; interestingly, for sufficiently low as well as sufficiently high R, we find conventional single-wave solutions despite temporary immunity. CONCLUSIONS: The versatility of our model, and its very modest demands on computational resources, ensure that a set of disease trajectories can be computed virtually on the same day that a new and relevant immune response study is released. Our work can also be used to analyse the disease dynamics after a vaccine is certified for use and information regarding its immune response becomes available.

First report of COVID-19 reinfection in a patient with beta thalassemia major.

To optimize care for patients with hemoglobinopathies, frequent screening for COVID-19 is prudent as viral kinetics in asplenic patients are unknown and differentiating prolonged viral shedding versus reinfection remains a challenge.