Possible Cases of SARS-CoV-2 Reinfection In Pekanbaru, Indonesia

Authors

  • Rahmat Azhari Kemal Department of Medical Biology, Faculty of Medicine Universitas Riau, Pekanbaru, Riau, Indonesia
  • Dewi Anggraini Department of Microbiology, Faculty of Medicine Universitas Riau, Pekanbaru, Riau, Indonesia

Keywords:

COVID-19, Indonesia, reinfection, SARS-CoV-2

Abstract

Confirmed and possible reinfection cases of SARS-CoV-2 have been reported from various countries. Here we present two cases of possible SARS-CoV-2 reinfection in Pekanbaru, Indonesia. A 26 years old female and a 27 years old male healthcare workers were first confirmed by PCR with high Ct-value (>35) while presenting no or mild symptoms, respectively. In more than one month since the last negative test results, both patients developed typical COVID-19 symptoms; fever and anosmia. RT-PCR results for SARS-CoV-2 were positive with Ct-value less than 30. The timeframe between 1st and 2nd episode, negative test result between episodes, and epidemiological risk factor strengthened the possibility of reinfection. However, we did not have whole genome sequence (WGS) or viral viability data to further confirm reinfection with different viable virus. The requirement of viral WGS data to confirm true reinfection cases calls for investment in whole genome sequencing platform in public health laboratories. We encourage standardized definition of SARS-CoV-2 reinfection case in order to be able to investigate and observe such cases.

Author Biographies

Rahmat Azhari Kemal, Department of Medical Biology, Faculty of Medicine Universitas Riau, Pekanbaru, Riau, Indonesia

Department of Medical Biology, Faculty of Medicine

Dewi Anggraini, Department of Microbiology, Faculty of Medicine Universitas Riau, Pekanbaru, Riau, Indonesia

Department of Microbiology, Faculty of Medicine

References

Iwasaki A. What reinfection means for COVID-19. Lancet Infect Dis. 2020; (published online Oct 12, 2020). DOI: 10.1016/S1473-3099(20)30783-0

To KKW, Hung IFN, Ip JD, et al. 2020. COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing. Clin Infect Dis. 2020; (published online Aug 25, 2020). DOI:10.1093/cid/ciaa1275

Tillett RL, Sevinsky JR, Hartley PD, et al. Genomic evidence for reinfection with SARS-CoV-2: a case study. Lancet Infect Dis. 2020;(published online Oct 12, 2020). DOI: 10.1016/S1473-3099(20)30764-7

van Elslande J, Vermeersch P, Vandervoort K, et al. Symptomatic SARS-CoV-2 reinfection by a phylogenetically distinct strain. Clin Infect Dis. 2020; (published online Sep 5, 2020). DOI: 10.1093/cid/ciaa1330

Prado-Vivar B, Becerra-Wong M, Guadalupe JJ, et al. COVID-19 re-infection by a phylogenetically distinct SARS-CoV-2 variant, first confirmed event in South America. SSRN. 2020; (published online Sep 8, 2020) [preprint]. DOI: 10.2139/ssrn.3686174

West J, Everden S, Nikitas N. A case of COVID-19 reinfection in the UK. Clin Med Dec. 2020. DOI: 10.7861/clinmed.2020-0912.

Duggan NM, Ludy SM, Shannon CB, Reisner AT, Wilcox SR. Is novel coronavirus 2019 reinfection possible? Interpreting dynamic SARS-CoV-2 test results. Am J Emerg Med. 2021; (published online Jul 4, 2020). DOI: 10.1016/j.ajem.2020.06.079

Akram L, Khan MHUR, Iqbal, Akram A. A case report of recurrent COVID-19 infection of a physician in Bangladesh: Re-infection or persistence infection? Bangladesh J Infect Dis. 2020;7(Suppl 2):S57-S60. DOI: 10.3329/bjid.v7i00.50164

Nachmias V, Fusman R, Mann S, Koren G. The first case of documented Covid-19 reinfection in Israel. IDCases 2020; 22: e00970. DOI: 10.1016/j.idcr.2020.e00970

Centers for Disease Control and Prevention. Common investigation protocol for suspected SARS-CoV-2 reinfection. 2020; (published online Oct 27, 2020)https://www.cdc.gov/coronavirus/2019-ncov/php/reinfection.html

Yahav D, Yelin D, Eckerle I, et al. Definitions for coronavirus disease 2019 reinfection, relapse and PCR re-positivity. Clin Microbiol Infect. 2020; (published online Dec 4, 2020). DOI: 10.1016/j.cmi.2020.11.028

Röltgen K, Powell AE, Wirz OF, et al. Defining the features and duration of antibody responses to SARS-CoV-2 infection associated with disease severity and outcome. Sci Immunol. 2020;5(54):eabe0240. DOI:10.1126/sciimmunol.abe0240.

Jeewandara C, Jayathilaka D, Gomes L, et al. SARS-CoV-2 neutralizing antibodies in patients with varying severity of acute COVID-19 illnes. Sci Rep. 2021; 11(1): 2062. DOI: 10.1038/s41598-021-81629-2.

Ibarrondo FJ, Fulcher JA, Goodman-Meza D, et al. Rapid decay of anti-SARS-CoV-2 antibodies in persons with mild Covid-19. N Engl J Med. 2020; 383(11): 1085-1087. DOI: 10.1056/NEJMc2025179.

Choe PG, Kim K-H, Kang CK, et al. Antibody responses 8 months after asymptomatic or mild SARS-CoV-2 infection. Emerg Infect Dis. 2021;(published online Dec 22, 2020). DOI: 10.3201/eid2703.204543

Rodda LB, Netland J, Shehata L, et al. Functional SARS-CoV-2-specific immune memomry persists after mild COVID-19. Cell. 2021;184(1):169-83.e17. DOI: 10.1016/j.cell.2020.11.029

Kim YI, Kim SM, Park SJ, et al. Critical role of neutralizing antibody for SARS-CoV-2 reinfection and transmission, Emerg Microbes Infect. 2021. DOI: 10.1080/22221751.2021.1872352

Kwong JC, Mccallum N, Sintchenko V, Howden BP. Whole genome sequencing in clinical and public health microbiology. Pathology. 2015;47(3):199-210.

Köser CU, Ellington MJ, Cartwright EJP, et al. Routine use of microbial whole genome sequencing in diagnostic and public health laboratory. Plos Pathog. 2021;8(8):e1002824.

Downloads

Published

2022-04-08

How to Cite

Kemal, R. A., & Anggraini, D. (2022). Possible Cases of SARS-CoV-2 Reinfection In Pekanbaru, Indonesia. Acta Medica Indonesiana, 54(1), 107. Retrieved from https://actamedindones.org/index.php/ijim/article/view/1789