Suspected COVID-19 Reinfections at a Tertiary Care Center, Iowa, 2020.
Suspected COVID-19 Reinfections at a Tertiary Care Center, Iowa, 2020.
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DOI：
10.1093/ofid/ofab188
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发表时间：
2021-07
影响因子：
4.2
通讯作者：
Pezzulo AA
中科院分区：
文献类型：
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作者：
Kobayashi T;Ortiz ME;Imborek KL;Alsuhaibani M;Holley SA;Trannel A;Marra AR;Etienne W;Jenn KE;Abosi OJ;Meacham H;Sheeler LL;Dains A;Kukla ME;McCray PB Jr;Perlman S;Ford B;Diekema DJ;Wellington M;Salinas JL;Pezzulo AA
尊敬的编辑：最近有严重急性呼吸综合征冠状病毒2（SARS-CoV-2）再感染的报道[1-5]。然而，再感染率很难确定，因为实时逆转录聚合酶链反应（RT-PCR）可以在感染后数周内检测SARS-CoV-2 RNA [6]，并且用于重新检测和定义再感染的标准也各不相同。此外，使用病毒全基因组测序（WGS）来证明新菌株或进化枝的再感染[1-5]尚未被广泛采用。美国疾病控制和预防中心（CDC）最近发布了2019年新型冠状病毒病（COVID-19）再感染调查方案，时间阈值为首次发病后≥ 45天，周期阈值（Ct）< 33 [7]。我们使用CDC调查方案来确定爱荷华州大学医院和诊所（UIHC;一个拥有811个床位的学术医疗中心）的临床疑似再感染率，并使用全基因组测序确认了1例再感染。有呼吸系统疾病的患者使用鼻咽拭子进行SARS-CoV-2 RT-PCR。在2020年3月至4月期间，使用CDC 2019-nCoVEUA-01诊断试剂盒（使用2个靶标，N1和N2基因）;大多数后续样本使用TaqPath RT-PCR COVID-19 Combo试剂盒进行检测，该试剂盒使用3个靶标（ORF 1ab，S基因，N基因）。我们确定了实验室确诊的COVID-19患者，这些患者在首次阳性检测后≥ 45天内接受了重复RT-PCR，以治疗新发呼吸道疾病。我们根据CDC疑似再感染的调查方案，在重复RT-PCR中确定了平均Ct值< 33的患者。我们对表1中的1对可用样品进行了WGS。
Dear Editor, Reinfections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been recently reported [1–5]. However, the rate of reinfections is difficult to determine because real-time reverse transcription polymerase chain reaction (RT-PCR) can detect SARS-CoV-2 RNA for weeks after infection [6] and criteria used to retest and define reinfections have varied. Moreover, use of viral whole-genome sequencing (WGS) to prove reinfection with new strains or clades [1–5] is not yet widely adopted. The Centers for Disease Control and Prevention (CDC) recently released a new coronavirus disease 2019 (COVID-19) reinfection investigation protocol with a time threshold of≥ 45 days from the first episode and a cycle threshold (Ct) of< 33 [7]. We used the CDC investigation protocol to determine the rate of clinically suspected reinfections at the University of Iowa Hospitals & Clinics (UIHC; an 811-bed academic medical center) and confirmed 1 reinfection using whole-genome sequencing. Patients with respiratory complaints underwent SARS-CoV-2 RT-PCR using nasopharyngeal swabs. During March–April 2020, the CDC 2019-nCoVEUA-01 Diagnostic Panel (which uses 2 targets, N1 and N2 genes) was used; most subsequent samples were tested with the TaqPath RT-PCR COVID-19 Combo kit, which uses 3 targets (ORF1ab, S gene, N gene). We identified patients with laboratory-confirmed COVID-19 who underwent repeat RT-PCR≥ 45 days from first positive test for new respiratory complaints. We identified patients with mean Ct values< 33 on repeat RT-PCR according to CDC investigation protocols for suspected reinfections. We performed WGS on 1 pair of available samples from Table 1.