Genomic evidence for reinfection with SARS-CoV-2: a case study.
Genomic evidence for reinfection with SARS-CoV-2: a case study.
复制标题
DOI：
10.1016/s1473-3099(20)30764-7
复制
发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Pandori M
中科院分区：
文献类型：
--
作者：
Tillett RL;Sevinsky JR;Hartley PD;Kerwin H;Crawford N;Gorzalski A;Laverdure C;Verma SC;Rossetto CC;Jackson D;Farrell MJ;Van Hooser S;Pandori M
感染严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)所产生的保护性免疫程度目前尚不清楚。因此，对SARS-CoV-2再次感染的可能性还没有很好的了解。我们描述了对同一人感染SARS-CoV-2的两例病例的调查。一名25岁的男子是美国内华达州瓦肖县的居民，他曾两次向卫生当局提出病毒感染的症状，一次是在2020年4月的一次社区检测活动中，第二次是在2020年5月底和6月初到初级保健医院。患者每次出现症状时均取鼻咽拭子，在随访期间取两次。用核酸扩增试验确认SARS-CoV-2感染。我们对从鼻咽拭子中提取的SARS-CoV-2进行了下一代测序。序列数据用两种不同的生物信息学方法进行评估。使用短串联重复标记进行片段分析，以确认这两种感染的样本来自同一个人。患者进行了两次SARS-CoV-2阳性检测，第一次是在2020年4月18日，第二次是在2020年6月5日，分别是在2020年5月的随访期间进行的两次阴性测试。对SARS-CoV-2病毒的基因组分析表明，与每个感染病例相关的每个变异株之间存在显著的遗传差异。第二次感染的症状比第一次严重。这两个SARS-CoV-2样本的遗传差异大于体内短期进化所能解释的。这些发现表明，患者曾两次被一种不同的基因病毒感染SARS-CoV-2。因此，以前接触SARS-CoV-2可能并不能保证在所有病例中都能完全免疫。所有人士，不论是否曾被诊断为感染新冠肺炎，均应采取相同的预防措施，避免感染SARS-CoV-2。再次感染的影响可能与疫苗的开发和应用有关。内华达州IDEA生物医学研究网络和国家普通医学科学研究所(国家卫生研究院)。
The degree of protective immunity conferred by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently unknown. As such, the possibility of reinfection with SARS-CoV-2 is not well understood. We describe an investigation of two instances of SARS-CoV-2 infection in the same individual. A 25-year-old man who was a resident of Washoe County in the US state of Nevada presented to health authorities on two occasions with symptoms of viral infection, once at a community testing event in April, 2020, and a second time to primary care then hospital at the end of May and beginning of June, 2020. Nasopharyngeal swabs were obtained from the patient at each presentation and twice during follow-up. Nucleic acid amplification testing was done to confirm SARS-CoV-2 infection. We did next-generation sequencing of SARS-CoV-2 extracted from nasopharyngeal swabs. Sequence data were assessed by two different bioinformatic methodologies. A short tandem repeat marker was used for fragment analysis to confirm that samples from both infections came from the same individual. The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first. Genetic discordance of the two SARS-CoV-2 specimens was greater than could be accounted for by short-term in vivo evolution. These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application. Nevada IDEA Network of Biomedical Research, and the National Institute of General Medical Sciences (National Institutes of Health).