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THREE SARS-COV-2 REINFECTION CASES BY THE NEW VARIANT OF CONCERN (VOC) P.1/501Y.V3
SARS-CoV-2
Virologia
Epidemiologia molecular
Reinfecção
Infecção secundária
Linhagem P.1
Amazonas
Brasil
Rede Genômica Fiocruz
GENOMAHCOV
Molecular Epidemiology
COVID-19
SARS-CoV-2
Reinfection
Secondary infection
Lineage P.1
Amazonas
Brazil
Author
Affilliation
Abstract in Portuguese
Neste relatório (pre-print), são apresentados três casos de reinfecção causados pela Variante de Preocupação (VOC) P.1, também conhecida como “cepa de Manaus”. As três pacientes eram mulheres adultas, e tiveram a primeira infecção durante a primeira onda da pandemia na primeira metade de 2020. Nos três casos, a linhagem detectada no primeiro diagnóstico molecular era diferente da encontrada posteriormente, evidência da reinfecção. Dois dos casos de reinfecção tiveram apresentação de sintomas leves, enquanto o terceiro foi assintomático, apesar de a quantidade de material genético viral detectado sugerir cargas virais elevadas. As evidências aqui apresentadas sugerem que a imunidade após infecção primária por linhagens anteriores à circulação daquelas contendo a mutação E484K não impede uma nova infecção pela variante P.1, e nem mesmo que pessoas reinfectadas por esta variante espalhem o vírus, embora seja possível que tenha protegido estas três pacientes do desenvolvimento de sintomas graves.
Abstract
The SARS-CoV-2 lineage B.1.1.28 has been evolving in Brazil since February 2020 giving origin to
multiple local clades including the new Variant of Concern (VOC) designated P.1 or 501Y.V3. The recent
emergence of sub-lineages with convergent mutations in the spike (S) protein raises concern about the
potential impact on viral infectivity and immune escape. We describe here the first three confirmed SARSCoV-2 reinfections cases with the new VOC P.1 in residents of the Amazonas state, Brazil. Three female patients, 29, 40, and 50-year-old, were RT-PCR confirmed for SARS-CoV-2 on two occasions, with at least 92 days apart. Next-generation sequencing and phylogenetic analysis were conducted to precisely access the SARS-CoV-2 lineages of each infection event. SARS-CoV-2 genomic analysis confirmed three cases of reinfections caused by the VOC P.1 in patients that were primo-infected by distinct viral lineages 3–9 months earlier. Case 1 (29-year-old) was positive on March 24, 2020 (lineage B.1.195) and then on December 30, 2020 (lineage P.1); case 2 (50-year-old) was positive on October 19, 2020 (lineage B.1.1.33) and on January 19, 2021 (lineage P.1); case 3 (40-year-old) was positive on April 22, 2020 (lineage B.1.195) and on January 29, 2021 (lineage P.1). The three patients displayed low mean Ct values (< 22) at nasopharyngeal samples and reported less severe illness during reinfection. The present study provides the first evidence of the new VOC P.1 causing multiple reinfections during the second epidemic peak in the Amazonas state. Our findings suggest that reinfected individuals may have been infectious. Although immune responses induced by natural infections do not necessarily prevent subsequent infections by the VOC P.1, they may still protect from severe disease.
Keywords in Portuguese
COVID-19SARS-CoV-2
Virologia
Epidemiologia molecular
Reinfecção
Infecção secundária
Linhagem P.1
Amazonas
Brasil
Rede Genômica Fiocruz
GENOMAHCOV
Keywords
VirologyMolecular Epidemiology
COVID-19
SARS-CoV-2
Reinfection
Secondary infection
Lineage P.1
Amazonas
Brazil
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