Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.
Identifieur interne : 000459 ( Main/Corpus ); précédent : 000458; suivant : 000460Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.
Auteurs : Jing Lu ; Jinju Peng ; Qianling Xiong ; Zhe Liu ; Huifang Lin ; Xiaohua Tan ; Min Kang ; Runyu Yuan ; Lilian Zeng ; Pingping Zhou ; Chumin Liang ; Lina Yi ; Louis Du Plessis ; Tie Song ; Wenjun Ma ; Jiufeng Sun ; Oliver G. Pybus ; Changwen KeSource :
- EBioMedicine [ 2352-3964 ] ; 2020.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Antibodies, Neutralizing (blood), Betacoronavirus (genetics), Betacoronavirus (isolation & purification), Child (MeSH), Child, Preschool (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (pathology), Coronavirus Infections (virology), Female (MeSH), Humans (MeSH), Infant (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Patient Discharge (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (pathology), Pneumonia, Viral (virology), RNA, Viral (chemistry), RNA, Viral (metabolism), Reverse Transcriptase Polymerase Chain Reaction (MeSH), Severity of Illness Index (MeSH), Whole Genome Sequencing (MeSH), Young Adult (MeSH).
- MESH :
- chemical , blood : Antibodies, Neutralizing.
- chemical , chemistry : RNA, Viral.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- genetics : Betacoronavirus.
- isolation & purification : Betacoronavirus.
- chemical , metabolism : RNA, Viral.
- pathology : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Pandemics, Patient Discharge, Reverse Transcriptase Polymerase Chain Reaction, Severity of Illness Index, Whole Genome Sequencing, Young Adult.
Abstract
BACKGROUND
Some COVID-19 cases test positive again for SARS-CoV-2 RNA following negative test results and discharge, raising questions about the meaning of virus detection. Better characterization of re-positive cases is urgently needed.
METHODS
Clinical data were obtained through Guangdong's COVID-19 surveillance network. Neutralization antibody titre was determined using microneutralization assays. Potential infectivity of clinical samples was evaluated by cell inoculation. SARS-CoV-2 RNA was detected using three different RT-PCR kits and multiplex PCR with nanopore sequencing.
FINDINGS
Among 619 discharged COVID-19 cases, 87 re-tested as SARS-CoV-2 positive in circumstances of social isolation. All re-positive cases had mild or moderate symptoms at initial diagnosis and were younger on average (median, 28). Re-positive cases (n = 59) exhibited similar neutralization antibodies (NAbs) titre distributions to other COVID-19 cases (n = 218) tested here. No infectious strain could be obtained by culture and no full-length viral genomes could be sequenced from re-positive cases.
INTERPRETATION
Re-positive SARS-CoV-2 cases do not appear to be caused by active reinfection and were identified in ~14% of discharged cases. A robust NAb response and potential virus genome degradation were detected in almost all re-positive cases, suggesting a substantially lower transmission risk, especially through respiratory routes.
DOI: 10.1016/j.ebiom.2020.102960
PubMed: 32853988
PubMed Central: PMC7444471
Links to Exploration step
pubmed:32853988Le document en format XML
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<author><name sortKey="Lu, Jing" sort="Lu, Jing" uniqKey="Lu J" first="Jing" last="Lu">Jing Lu</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Peng, Jinju" sort="Peng, Jinju" uniqKey="Peng J" first="Jinju" last="Peng">Jinju Peng</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Xiong, Qianling" sort="Xiong, Qianling" uniqKey="Xiong Q" first="Qianling" last="Xiong">Qianling Xiong</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Liu, Zhe" sort="Liu, Zhe" uniqKey="Liu Z" first="Zhe" last="Liu">Zhe Liu</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Lin, Huifang" sort="Lin, Huifang" uniqKey="Lin H" first="Huifang" last="Lin">Huifang Lin</name>
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</affiliation>
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<author><name sortKey="Tan, Xiaohua" sort="Tan, Xiaohua" uniqKey="Tan X" first="Xiaohua" last="Tan">Xiaohua Tan</name>
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</affiliation>
</author>
<author><name sortKey="Kang, Min" sort="Kang, Min" uniqKey="Kang M" first="Min" last="Kang">Min Kang</name>
<affiliation><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Yuan, Runyu" sort="Yuan, Runyu" uniqKey="Yuan R" first="Runyu" last="Yuan">Runyu Yuan</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Zeng, Lilian" sort="Zeng, Lilian" uniqKey="Zeng L" first="Lilian" last="Zeng">Lilian Zeng</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Zhou, Pingping" sort="Zhou, Pingping" uniqKey="Zhou P" first="Pingping" last="Zhou">Pingping Zhou</name>
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<author><name sortKey="Liang, Chumin" sort="Liang, Chumin" uniqKey="Liang C" first="Chumin" last="Liang">Chumin Liang</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Yi, Lina" sort="Yi, Lina" uniqKey="Yi L" first="Lina" last="Yi">Lina Yi</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Du Plessis, Louis" sort="Du Plessis, Louis" uniqKey="Du Plessis L" first="Louis" last="Du Plessis">Louis Du Plessis</name>
<affiliation><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation>
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<author><name sortKey="Song, Tie" sort="Song, Tie" uniqKey="Song T" first="Tie" last="Song">Tie Song</name>
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<author><name sortKey="Ma, Wenjun" sort="Ma, Wenjun" uniqKey="Ma W" first="Wenjun" last="Ma">Wenjun Ma</name>
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<author><name sortKey="Sun, Jiufeng" sort="Sun, Jiufeng" uniqKey="Sun J" first="Jiufeng" last="Sun">Jiufeng Sun</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: sunjiuf@163.com.</nlm:affiliation>
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<author><name sortKey="Pybus, Oliver G" sort="Pybus, Oliver G" uniqKey="Pybus O" first="Oliver G" last="Pybus">Oliver G. Pybus</name>
<affiliation><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Ke, Changwen" sort="Ke, Changwen" uniqKey="Ke C" first="Changwen" last="Ke">Changwen Ke</name>
<affiliation><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: kecw1965@aliyun.com.</nlm:affiliation>
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<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Liu, Zhe" sort="Liu, Zhe" uniqKey="Liu Z" first="Zhe" last="Liu">Zhe Liu</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Lin, Huifang" sort="Lin, Huifang" uniqKey="Lin H" first="Huifang" last="Lin">Huifang Lin</name>
<affiliation><nlm:affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
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<author><name sortKey="Tan, Xiaohua" sort="Tan, Xiaohua" uniqKey="Tan X" first="Xiaohua" last="Tan">Xiaohua Tan</name>
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<author><name sortKey="Kang, Min" sort="Kang, Min" uniqKey="Kang M" first="Min" last="Kang">Min Kang</name>
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<author><name sortKey="Yuan, Runyu" sort="Yuan, Runyu" uniqKey="Yuan R" first="Runyu" last="Yuan">Runyu Yuan</name>
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<author><name sortKey="Zeng, Lilian" sort="Zeng, Lilian" uniqKey="Zeng L" first="Lilian" last="Zeng">Lilian Zeng</name>
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<author><name sortKey="Zhou, Pingping" sort="Zhou, Pingping" uniqKey="Zhou P" first="Pingping" last="Zhou">Pingping Zhou</name>
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</affiliation>
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<author><name sortKey="Liang, Chumin" sort="Liang, Chumin" uniqKey="Liang C" first="Chumin" last="Liang">Chumin Liang</name>
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<author><name sortKey="Yi, Lina" sort="Yi, Lina" uniqKey="Yi L" first="Lina" last="Yi">Lina Yi</name>
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</affiliation>
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<author><name sortKey="Du Plessis, Louis" sort="Du Plessis, Louis" uniqKey="Du Plessis L" first="Louis" last="Du Plessis">Louis Du Plessis</name>
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</affiliation>
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<author><name sortKey="Song, Tie" sort="Song, Tie" uniqKey="Song T" first="Tie" last="Song">Tie Song</name>
<affiliation><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Ma, Wenjun" sort="Ma, Wenjun" uniqKey="Ma W" first="Wenjun" last="Ma">Wenjun Ma</name>
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</affiliation>
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<author><name sortKey="Sun, Jiufeng" sort="Sun, Jiufeng" uniqKey="Sun J" first="Jiufeng" last="Sun">Jiufeng Sun</name>
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</affiliation>
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<author><name sortKey="Pybus, Oliver G" sort="Pybus, Oliver G" uniqKey="Pybus O" first="Oliver G" last="Pybus">Oliver G. Pybus</name>
<affiliation><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation>
</affiliation>
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<author><name sortKey="Ke, Changwen" sort="Ke, Changwen" uniqKey="Ke C" first="Changwen" last="Ke">Changwen Ke</name>
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<term>Betacoronavirus (genetics)</term>
<term>Betacoronavirus (isolation & purification)</term>
<term>Child (MeSH)</term>
<term>Child, Preschool (MeSH)</term>
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<term>Coronavirus Infections (pathology)</term>
<term>Coronavirus Infections (virology)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Infant (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Patient Discharge (MeSH)</term>
<term>Pneumonia, Viral (diagnosis)</term>
<term>Pneumonia, Viral (pathology)</term>
<term>Pneumonia, Viral (virology)</term>
<term>RNA, Viral (chemistry)</term>
<term>RNA, Viral (metabolism)</term>
<term>Reverse Transcriptase Polymerase Chain Reaction (MeSH)</term>
<term>Severity of Illness Index (MeSH)</term>
<term>Whole Genome Sequencing (MeSH)</term>
<term>Young Adult (MeSH)</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Some COVID-19 cases test positive again for SARS-CoV-2 RNA following negative test results and discharge, raising questions about the meaning of virus detection. Better characterization of re-positive cases is urgently needed.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Clinical data were obtained through Guangdong's COVID-19 surveillance network. Neutralization antibody titre was determined using microneutralization assays. Potential infectivity of clinical samples was evaluated by cell inoculation. SARS-CoV-2 RNA was detected using three different RT-PCR kits and multiplex PCR with nanopore sequencing.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>FINDINGS</b>
</p>
<p>Among 619 discharged COVID-19 cases, 87 re-tested as SARS-CoV-2 positive in circumstances of social isolation. All re-positive cases had mild or moderate symptoms at initial diagnosis and were younger on average (median, 28). Re-positive cases (n = 59) exhibited similar neutralization antibodies (NAbs) titre distributions to other COVID-19 cases (n = 218) tested here. No infectious strain could be obtained by culture and no full-length viral genomes could be sequenced from re-positive cases.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b>
</p>
<p>Re-positive SARS-CoV-2 cases do not appear to be caused by active reinfection and were identified in ~14% of discharged cases. A robust NAb response and potential virus genome degradation were detected in almost all re-positive cases, suggesting a substantially lower transmission risk, especially through respiratory routes.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32853988</PMID>
<DateCompleted><Year>2020</Year>
<Month>09</Month>
<Day>30</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>10</Month>
<Day>01</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2352-3964</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>59</Volume>
<PubDate><Year>2020</Year>
<Month>Sep</Month>
</PubDate>
</JournalIssue>
<Title>EBioMedicine</Title>
<ISOAbbreviation>EBioMedicine</ISOAbbreviation>
</Journal>
<ArticleTitle>Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.</ArticleTitle>
<Pagination><MedlinePgn>102960</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S2352-3964(20)30336-4</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ebiom.2020.102960</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Some COVID-19 cases test positive again for SARS-CoV-2 RNA following negative test results and discharge, raising questions about the meaning of virus detection. Better characterization of re-positive cases is urgently needed.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Clinical data were obtained through Guangdong's COVID-19 surveillance network. Neutralization antibody titre was determined using microneutralization assays. Potential infectivity of clinical samples was evaluated by cell inoculation. SARS-CoV-2 RNA was detected using three different RT-PCR kits and multiplex PCR with nanopore sequencing.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">Among 619 discharged COVID-19 cases, 87 re-tested as SARS-CoV-2 positive in circumstances of social isolation. All re-positive cases had mild or moderate symptoms at initial diagnosis and were younger on average (median, 28). Re-positive cases (n = 59) exhibited similar neutralization antibodies (NAbs) titre distributions to other COVID-19 cases (n = 218) tested here. No infectious strain could be obtained by culture and no full-length viral genomes could be sequenced from re-positive cases.</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">Re-positive SARS-CoV-2 cases do not appear to be caused by active reinfection and were identified in ~14% of discharged cases. A robust NAb response and potential virus genome degradation were detected in almost all re-positive cases, suggesting a substantially lower transmission risk, especially through respiratory routes.</AbstractText>
<CopyrightInformation>Copyright © 2020. Published by Elsevier B.V.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lu</LastName>
<ForeName>Jing</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Peng</LastName>
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<AffiliationInfo><Affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</Affiliation>
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<ForeName>Tie</ForeName>
<Initials>T</Initials>
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<AffiliationInfo><Affiliation>Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, 160 Qunxian Rd, Dashi Town, Panyu District, Guangdong Province, Guangzhou 511430, China; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: sunjiuf@163.com.</Affiliation>
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<ForeName>Changwen</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: kecw1965@aliyun.com.</Affiliation>
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<Language>eng</Language>
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<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>08</Month>
<Day>24</Day>
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<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>EBioMedicine</MedlineTA>
<NlmUniqueID>101647039</NlmUniqueID>
<ISSNLinking>2352-3964</ISSNLinking>
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<MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName>
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<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
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<MeshHeading><DescriptorName UI="D020133" MajorTopicYN="N">Reverse Transcriptase Polymerase Chain Reaction</DescriptorName>
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<MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName>
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<MeshHeading><DescriptorName UI="D000073336" MajorTopicYN="N">Whole Genome Sequencing</DescriptorName>
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<MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">Neutralizing antibody</Keyword>
<Keyword MajorTopicYN="N">Re-positive</Keyword>
<Keyword MajorTopicYN="N">SARS-CoV-2</Keyword>
<Keyword MajorTopicYN="N">Virology</Keyword>
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<CoiStatement>Declaration of Competing Interests All authors: No reported conflicts of interest.</CoiStatement>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year>
<Month>06</Month>
<Day>18</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2020</Year>
<Month>07</Month>
<Day>31</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>07</Month>
<Day>31</Day>
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<PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>8</Month>
<Day>28</Day>
<Hour>6</Hour>
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<Month>10</Month>
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<Month>8</Month>
<Day>28</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<ArticleIdList><ArticleId IdType="pubmed">32853988</ArticleId>
<ArticleId IdType="pii">S2352-3964(20)30336-4</ArticleId>
<ArticleId IdType="doi">10.1016/j.ebiom.2020.102960</ArticleId>
<ArticleId IdType="pmc">PMC7444471</ArticleId>
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