Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.
Identifieur interne : 000738 ( Main/Exploration ); précédent : 000737; suivant : 000739Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.
Auteurs : Jing Lu [République populaire de Chine] ; Jinju Peng [République populaire de Chine] ; Qianling Xiong [République populaire de Chine] ; Zhe Liu [République populaire de Chine] ; Huifang Lin [République populaire de Chine] ; Xiaohua Tan [République populaire de Chine] ; Min Kang [République populaire de Chine] ; Runyu Yuan [République populaire de Chine] ; Lilian Zeng [République populaire de Chine] ; Pingping Zhou [République populaire de Chine] ; Chumin Liang [République populaire de Chine] ; Lina Yi [République populaire de Chine] ; Louis Du Plessis [Royaume-Uni] ; Tie Song [République populaire de Chine] ; Wenjun Ma [République populaire de Chine] ; Jiufeng Sun [République populaire de Chine] ; Oliver G. Pybus [Royaume-Uni] ; Changwen Ke [République populaire de Chine]Source :
- EBioMedicine [ 2352-3964 ] ; 2020.
Descripteurs français
- KwdFr :
- ARN viral (composition chimique), ARN viral (métabolisme), Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Anticorps neutralisants (sang), Betacoronavirus (génétique), Betacoronavirus (isolement et purification), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Femelle (MeSH), Humains (MeSH), Indice de gravité de la maladie (MeSH), Infections à coronavirus (anatomopathologie), Infections à coronavirus (diagnostic), Infections à coronavirus (virologie), Jeune adulte (MeSH), Mâle (MeSH), Nourrisson (MeSH), Pandémies (MeSH), Pneumopathie virale (anatomopathologie), Pneumopathie virale (diagnostic), Pneumopathie virale (virologie), RT-PCR (MeSH), Sortie du patient (MeSH), Sujet âgé (MeSH), Séquençage du génome entier (MeSH).
- MESH :
- anatomopathologie : Infections à coronavirus, Pneumopathie virale.
- composition chimique : ARN viral.
- diagnostic : Infections à coronavirus, Pneumopathie virale.
- génétique : Betacoronavirus.
- isolement et purification : Betacoronavirus.
- métabolisme : ARN viral.
- sang : Anticorps neutralisants.
- virologie : Infections à coronavirus, Pneumopathie virale.
- Adolescent, Adulte, Adulte d'âge moyen, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Indice de gravité de la maladie, Jeune adulte, Mâle, Nourrisson, Pandémies, RT-PCR, Sortie du patient, Sujet âgé, Séquençage du génome entier.
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
Affiliations:
- Royaume-Uni, République populaire de Chine
- Angleterre, Guangdong, Oxfordshire
- Jiangmen, Oxford
- Université d'Oxford
Links toward previous steps (curation, corpus...)
Le document en format XML
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Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Zeng, Lilian" sort="Zeng, Lilian" uniqKey="Zeng L" first="Lilian" last="Zeng">Lilian Zeng</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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; 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Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Yi, Lina" sort="Yi, Lina" uniqKey="Yi L" first="Lina" last="Yi">Lina Yi</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Du Plessis, Louis" sort="Du Plessis, Louis" uniqKey="Du Plessis L" first="Louis" last="Du Plessis">Louis Du Plessis</name><affiliation wicri:level="4"><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Zoology, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Song, Tie" sort="Song, Tie" uniqKey="Song T" first="Tie" last="Song">Tie Song</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Ma, Wenjun" sort="Ma, Wenjun" uniqKey="Ma W" first="Wenjun" last="Ma">Wenjun Ma</name><affiliation wicri:level="1"><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.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Sun, Jiufeng" sort="Sun, Jiufeng" uniqKey="Sun J" first="Jiufeng" last="Sun">Jiufeng Sun</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Pybus, Oliver G" sort="Pybus, Oliver G" uniqKey="Pybus O" first="Oliver G" last="Pybus">Oliver G. Pybus</name><affiliation wicri:level="4"><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Zoology, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Ke, Changwen" sort="Ke, Changwen" uniqKey="Ke C" first="Changwen" last="Ke">Changwen Ke</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: kecw1965@aliyun.com.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32853988</idno><idno type="pmid">32853988</idno><idno type="doi">10.1016/j.ebiom.2020.102960</idno><idno type="pmc">PMC7444471</idno><idno type="wicri:Area/Main/Corpus">000459</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000459</idno><idno type="wicri:Area/Main/Curation">000459</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000459</idno><idno type="wicri:Area/Main/Exploration">000459</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR.</title><author><name sortKey="Lu, Jing" sort="Lu, Jing" uniqKey="Lu J" first="Jing" last="Lu">Jing Lu</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Peng, Jinju" sort="Peng, Jinju" uniqKey="Peng J" first="Jinju" last="Peng">Jinju Peng</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Xiong, Qianling" sort="Xiong, Qianling" uniqKey="Xiong Q" first="Qianling" last="Xiong">Qianling Xiong</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Liu, Zhe" sort="Liu, Zhe" uniqKey="Liu Z" first="Zhe" last="Liu">Zhe Liu</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Lin, Huifang" sort="Lin, Huifang" uniqKey="Lin H" first="Huifang" last="Lin">Huifang Lin</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Tan, Xiaohua" sort="Tan, Xiaohua" uniqKey="Tan X" first="Xiaohua" last="Tan">Xiaohua Tan</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Kang, Min" sort="Kang, Min" uniqKey="Kang M" first="Min" last="Kang">Min Kang</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Yuan, Runyu" sort="Yuan, Runyu" uniqKey="Yuan R" first="Runyu" last="Yuan">Runyu Yuan</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Zeng, Lilian" sort="Zeng, Lilian" uniqKey="Zeng L" first="Lilian" last="Zeng">Lilian Zeng</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Zhou, Pingping" sort="Zhou, Pingping" uniqKey="Zhou P" first="Pingping" last="Zhou">Pingping Zhou</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Liang, Chumin" sort="Liang, Chumin" uniqKey="Liang C" first="Chumin" last="Liang">Chumin Liang</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Yi, Lina" sort="Yi, Lina" uniqKey="Yi L" first="Lina" last="Yi">Lina Yi</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Du Plessis, Louis" sort="Du Plessis, Louis" uniqKey="Du Plessis L" first="Louis" last="Du Plessis">Louis Du Plessis</name><affiliation wicri:level="4"><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Zoology, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Song, Tie" sort="Song, Tie" uniqKey="Song T" first="Tie" last="Song">Tie Song</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Ma, Wenjun" sort="Ma, Wenjun" uniqKey="Ma W" first="Wenjun" last="Ma">Wenjun Ma</name><affiliation wicri:level="1"><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.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Sun, Jiufeng" sort="Sun, Jiufeng" uniqKey="Sun J" first="Jiufeng" last="Sun">Jiufeng Sun</name><affiliation wicri:level="3"><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><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>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</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author><author><name sortKey="Pybus, Oliver G" sort="Pybus, Oliver G" uniqKey="Pybus O" first="Oliver G" last="Pybus">Oliver G. Pybus</name><affiliation wicri:level="4"><nlm:affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Zoology, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Ke, Changwen" sort="Ke, Changwen" uniqKey="Ke C" first="Changwen" last="Ke">Changwen Ke</name><affiliation wicri:level="3"><nlm:affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: kecw1965@aliyun.com.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou</wicri:regionArea><placeName><settlement type="city">Jiangmen</settlement><region type="province">Guangdong</region></placeName></affiliation></author></analytic><series><title level="j">EBioMedicine</title><idno type="eISSN">2352-3964</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Antibodies, Neutralizing (blood)</term><term>Betacoronavirus (genetics)</term><term>Betacoronavirus (isolation & purification)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><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></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>ARN viral (composition chimique)</term><term>ARN viral (métabolisme)</term><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Anticorps neutralisants (sang)</term><term>Betacoronavirus (génétique)</term><term>Betacoronavirus (isolement et purification)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Infections à coronavirus (anatomopathologie)</term><term>Infections à coronavirus (diagnostic)</term><term>Infections à coronavirus (virologie)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Nourrisson (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (anatomopathologie)</term><term>Pneumopathie virale (diagnostic)</term><term>Pneumopathie virale (virologie)</term><term>RT-PCR (MeSH)</term><term>Sortie du patient (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Séquençage du génome entier (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Neutralizing</term></keywords><keywords scheme="MESH" type="chemical" qualifier="chemistry" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="composition chimique" xml:lang="fr"><term>ARN viral</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>RNA, Viral</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>ARN viral</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticorps neutralisants</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Patient Discharge</term><term>Reverse Transcriptase Polymerase Chain Reaction</term><term>Severity of Illness Index</term><term>Whole Genome Sequencing</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Jeune adulte</term><term>Mâle</term><term>Nourrisson</term><term>Pandémies</term><term>RT-PCR</term><term>Sortie du patient</term><term>Sujet âgé</term><term>Séquençage du génome entier</term></keywords></textClass></profileDesc></teiHeader><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></Author><Author ValidYN="Y"><LastName>Peng</LastName><ForeName>Jinju</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></Author><Author ValidYN="Y"><LastName>Xiong</LastName><ForeName>Qianling</ForeName><Initials>Q</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></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Zhe</ForeName><Initials>Z</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lin</LastName><ForeName>Huifang</ForeName><Initials>H</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tan</LastName><ForeName>Xiaohua</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kang</LastName><ForeName>Min</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yuan</LastName><ForeName>Runyu</ForeName><Initials>R</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeng</LastName><ForeName>Lilian</ForeName><Initials>L</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Pingping</ForeName><Initials>P</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liang</LastName><ForeName>Chumin</ForeName><Initials>C</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yi</LastName><ForeName>Lina</ForeName><Initials>L</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>du Plessis</LastName><ForeName>Louis</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Song</LastName><ForeName>Tie</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Wenjun</ForeName><Initials>W</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.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sun</LastName><ForeName>Jiufeng</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. Electronic address: sunjiuf@163.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pybus</LastName><ForeName>Oliver G</ForeName><Initials>OG</Initials><AffiliationInfo><Affiliation>Department of Zoology, University of Oxford, Oxford, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ke</LastName><ForeName>Changwen</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China. Electronic address: kecw1965@aliyun.com.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>EBioMedicine</MedlineTA><NlmUniqueID>101647039</NlmUniqueID><ISSNLinking>2352-3964</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D057134">Antibodies, Neutralizing</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D012367">RNA, Viral</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057134" MajorTopicYN="N">Antibodies, Neutralizing</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010351" MajorTopicYN="N">Patient Discharge</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012367" MajorTopicYN="N">RNA, Viral</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="N">chemistry</QualifierName><QualifierName UI="Q000378" MajorTopicYN="Y">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020133" MajorTopicYN="N">Reverse Transcriptase Polymerase Chain Reaction</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073336" MajorTopicYN="N">Whole Genome Sequencing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><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></KeywordList><CoiStatement>Declaration of Competing Interests All authors: No reported conflicts of interest.</CoiStatement></MedlineCitation><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></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><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></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li><li>République populaire de Chine</li></country><region><li>Angleterre</li><li>Guangdong</li><li>Oxfordshire</li></region><settlement><li>Jiangmen</li><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li></orgName></list><tree><country name="République populaire de Chine"><region name="Guangdong"><name sortKey="Lu, Jing" sort="Lu, Jing" uniqKey="Lu J" first="Jing" last="Lu">Jing Lu</name></region><name sortKey="Kang, Min" sort="Kang, Min" uniqKey="Kang M" first="Min" last="Kang">Min Kang</name><name sortKey="Ke, Changwen" sort="Ke, Changwen" uniqKey="Ke C" first="Changwen" last="Ke">Changwen Ke</name><name sortKey="Liang, Chumin" sort="Liang, Chumin" uniqKey="Liang C" first="Chumin" last="Liang">Chumin Liang</name><name sortKey="Lin, Huifang" sort="Lin, Huifang" uniqKey="Lin H" first="Huifang" last="Lin">Huifang Lin</name><name sortKey="Liu, Zhe" sort="Liu, Zhe" uniqKey="Liu Z" first="Zhe" last="Liu">Zhe Liu</name><name sortKey="Ma, Wenjun" sort="Ma, Wenjun" uniqKey="Ma W" first="Wenjun" last="Ma">Wenjun Ma</name><name sortKey="Peng, Jinju" sort="Peng, Jinju" uniqKey="Peng J" first="Jinju" last="Peng">Jinju Peng</name><name sortKey="Song, Tie" sort="Song, Tie" uniqKey="Song T" first="Tie" last="Song">Tie Song</name><name sortKey="Sun, Jiufeng" sort="Sun, Jiufeng" uniqKey="Sun J" first="Jiufeng" last="Sun">Jiufeng Sun</name><name sortKey="Tan, Xiaohua" sort="Tan, Xiaohua" uniqKey="Tan X" first="Xiaohua" last="Tan">Xiaohua Tan</name><name sortKey="Xiong, Qianling" sort="Xiong, Qianling" uniqKey="Xiong Q" first="Qianling" last="Xiong">Qianling Xiong</name><name sortKey="Yi, Lina" sort="Yi, Lina" uniqKey="Yi L" first="Lina" last="Yi">Lina Yi</name><name sortKey="Yuan, Runyu" sort="Yuan, Runyu" uniqKey="Yuan R" first="Runyu" last="Yuan">Runyu Yuan</name><name sortKey="Zeng, Lilian" sort="Zeng, Lilian" uniqKey="Zeng L" first="Lilian" last="Zeng">Lilian Zeng</name><name sortKey="Zhou, Pingping" sort="Zhou, Pingping" uniqKey="Zhou P" first="Pingping" last="Zhou">Pingping Zhou</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Du Plessis, Louis" sort="Du Plessis, Louis" uniqKey="Du Plessis L" first="Louis" last="Du Plessis">Louis Du Plessis</name></region><name sortKey="Pybus, Oliver G" sort="Pybus, Oliver G" uniqKey="Pybus O" first="Oliver G" last="Pybus">Oliver G. 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