Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Coronavirus Disease 2019 Recovered Young Adult

A Case Report

Hussein Awada; Hasan Nassereldine; Adel Hajj Ali

Disclosures

J Med Case Reports. 2021;15(382) 

In This Article

Abstract and Introduction

Abstract

Background: Coronavirus disease 2019 has been a public health threat and a worldwide emergency for more than a year. Unfortunately, many questions concerning the pathophysiology, management, and long-term side effects remain unanswered, and novel aspects of the disease keep on emerging. Of concern to healthcare providers are the recent reported cases of reinfection. Serum coronavirus disease 2019 antibodies have been detected within a few days after onset of the disease. However, it remains unclear whether this immune response is universal, or whether it can lead to latent immunity.

Case Presentation: A previously healthy 27-year-old white man presented with fever, chills, back pain, and other constitutional symptoms, 2 days after being exposed to coronavirus disease 2019 positive patients. His severe acute respiratory syndrome coronavirus 2 polymerase chain reaction was positive, and his symptoms resolved over the next 2 weeks. One month after a confirmatory negative severe acute respiratory syndrome coronavirus 2 polymerase chain reaction, he was found to be ineligible for plasma donation as his anti-severe acute respiratory syndrome coronavirus 2 serology was negative. The patient redeveloped symptoms similar to his first infection 3 weeks after the negative serology test. He and his wife both tested positive via polymerase chain reaction. Their symptoms resolved over the next few days, and they had a negative polymerase chain reaction test 10 days after the positive polymerase chain reaction.

Conclusion: While studies showed that anti-severe acute respiratory syndrome coronavirus 2 immunoglobulins start to develop early after infection, our healthy young patient's immune system failed to mount latent immunity against the virus. This left him, especially amid widespread social and medical misconceptions, vulnerable to reinfection by severe acute respiratory syndrome coronavirus 2. Our case disputes the timelines for immune response that were set and supported by research studies. Our case also raises questions regarding prioritizing vaccinating other individuals over those with prior infection.

Introduction

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first appeared in Wuhan, China, in December 2019.[1] Since then, COVID-19 has rapidly spread across the world, and it has been declared as a global pandemic by the World Health Organization (WHO).[1] In Lebanon, the first case was documented on 21 February 2020, and to date, more than 280,000 cases and 2300 deaths have been recorded.[2,3] While the majority of patients recover from COVID-19 worldwide, a growing concern about reinfection has been developing due to the increasing number of recovered patients who have been reported to have tested positive again.[4,5] Some of these reports have been contested as false positives, while others have been attributed to quick reexposure before a protective immune response has been mounted. Nevertheless, many studies did demonstrate that recovered COVID-19 patients do develop antibodies against SARS-CoV-2.[6–8] While there is no clear evidence whether all patients do develop protective latent immunity or how long may it last, several studies emphasized the improbability of reinfection due to a postinfection immunity that is at least short and temporary.[4,9,10] In this paper, we report a unique case of a patient, from Lebanon, who recovered from COVID-19 before getting reinfected with SARS-CoV-2 within 2 months of initial recovery.

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