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?:abstract
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Can a patient diagnosed with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) be infected again? This question is still unsolved We tried to analyze local and literature cases with a positive respiratory swab after recovery We collected data from symptomatic patients diagnosed with SARS-CoV-2 infection in the Italian Umbria Region that, after recovery, were again positive for SARS-CoV-2 in respiratory tract specimens Samples were also assessed for infectivity in vitro A systematic review of similar cases reported in the literature was performed The study population was composed of 9 patients during a 4-month study period Among the new positive samples, six were inoculated in Vero-E6 cells and showed no growth and negative molecular test in culture supernatants All patients were positive for IgG against SARS-CoV-2 nucleoprotein and/or S protein Conducting a review of the literature, 1350 similar cases have been found The presumptive reactivation occurred in 34 5 days on average (standard deviation, SD, 18 7 days) after COVID-19 onset, when the 5 6% of patients presented fever and the 27 6% symptoms The outcome was favorable in 96 7% of patients, while the 1 1% of them were still hospitalized at the time of data collection and the 2 1% died Several hypotheses have been formulated to explain new positive respiratory samples after confirmed negativity According to this study, the phenomenon seems to be due to the prolonged detection of SARS-CoV-2 RNA traces in respiratory samples of recovered patients The failure of the virus to replicate in vitro suggests its inability to replicate in vivo
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