International Medical Case Reports Journal (Oct 2020)
Second Episode of COVID-19 in Health Professionals: Report of Two Cases
Abstract
Carlos Alexandre Antunes de Brito,1,2 Petrus Moura Andrade Lima,3 Marina Coelho Moraes de Brito,2,4 Daniela Barbosa de Oliveira2 1Department of Internal Medicine, Center of Medical Sciences of Federal University, Recife, Pernambuco, Brazil; 2Department of Immunology, Autoimmune Research Institute, Recife, Pernambuco, Brazil; 3Department of Digestive Surgery, Institute of Integral Medicine Fernando Figueira (IMIP), Recife, Pernambuco, Brazil; 4Center of Medical Sciences, Federal University of Pernambuco, Recife, Pernambuco, BrazilCorrespondence: Carlos Alexandre Antunes de Brito Av. Professor Moraes Rego, s/n, Várzea, Department of Internal MedicineFederal University of Pernambuco, Recife 50670-910, Pernambuco, BrazilTel +55 (81) 2126.3699Email [email protected]: Although primary infection has been shown to prevent reinfection of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in animal models, gaps in the understanding of the immune response to the virus have not been adequately addressed, and some cases of possible reinfection have been reported; however, the frequency, relevance and proof of these events have yet to be determined. We report cases of two doctors who had two episodes of COVID-19 with positive RT-PCR (reverse transcriptase polymerase chain reaction) test results, raising the probability of reinfection. Case 1 was a 40-year-old male physician who presented fever and respiratory symptoms on April 10, with a positive RT-PCR test for SARS-CoV-2, with complete improvement of symptoms in five days. After 44 days, the patient presented the same symptoms of the previous episode, associated with anosmia and dysgeusia. The results of a new RT-PCR test performed two days later were positive for SARS-CoV-2. Case 2 was a 44-year-old female physician who worked in a reference clinic for COVID-19 (coronavirus disease 2019) and had onset of symptoms indicative of the disease on April 30. The RT-PCR test was positive for SARS-CoV-2, with improvement of symptoms in six days. On May 24, the patient presented fever, cough, and sore throat accompanied by headache, asthenia, myalgia, and diarrhea, and in this new episode, anosmia and dysgeusia were also present. A new RT-PCR test from nasopharyngeal swabs was performed with a positive result. Our two patients described here and other patients with possible reinfection who are now being observed in clinical practice reinforce the need to expand the investigation. Then, if the risk of reinfection is confirmed, these findings will be relevant from a clinical-epidemiological perspective to define isolation strategies and develop vaccines.Keywords: COVID-19, SARS-CoV-2, reinfection, antibody
