key: cord-0900711-73mbmecr
authors: Gupta, Vivek; Bhoyar, Rahul C; Jain, Abhinav; Srivastava, Saurabh; Upadhayay, Rashmi; Imran, Mohamed; Jolly, Bani; Divakar, Mohit Kumar; Sharma, Disha; Sehgal, Paras; Ranjan, Gyan; Gupta, Rakesh; Scaria, Vinod; Sivasubbu, Sridhar
title: Asymptomatic reinfection in two healthcare workers from India with genetically distinct SARS-CoV-2
date: 2020-09-23
journal: Clin Infect Dis
DOI: 10.1093/cid/ciaa1451
sha: 042fb96c9490fd5a9d1255a5b3ac5810e6ea076a
doc_id: 900711
cord_uid: 73mbmecr

nan

M a n u s c r i p t 2 Dear Editor, To et al [1] recently reported a case of SARS-CoV-2 reinfection confirmed by genome sequencing.

Additional reports of genetically characterized reinfections have emerged [2, 3] A c c e p t e d M a n u s c r i p t 3 and 92.14% for I2. Analysis of the genomes using a previously published protocol [4] for loci covered in both the genomes revealed 9 and 10 unique variant differences between the virus isolates from the two episodes of infection for I1 and I2 respectively ( Figure 1B) . Of the unique variants between the pair of samples, seven variants each for the two individuals mapped to predicted immune epitopes [5] .

Taken together our analysis suggests that asymptomatic reinfection may be a potentially underreported entity. Genetically distinct SARS-CoV-2 rules out persistent viral shedding or reactivation.

Both individuals had a higher viral load during reinfection highlighting the need for continuous surveillance. It is noteworthy that a genetic variant 22882T>G (S: N440K) found during reinfection in I2 possibly confers resistance to neutralising antibodies [6] . To the best of our knowledge, this is one of the earliest reports of genetically characterized reinfection from India. A c c e p t e d M a n u s c r i p t 

COVID-19 re-infection by a phylogenetically distinct SARScoronavirus-2 strain confirmed by whole genome sequencing

Symptomatic SARS-CoV-2 reinfection by a phylogenetically distinct strain

Genomic Evidence for a Case of Reinfection with SARS-CoV-2

Computational Protocol for Assembly and Analysis of SARS-nCoV-2 Genomes

A Sequence Homology and Bioinformatic Approach Can Predict Candidate Targets for Immune Responses to SARS-CoV-2

Escape from neutralizing antibodies by SARS-CoV-2 spike protein variants

A c c e p t e d M a n u s c r i p t A c c e p t e d M a n u s c r i p t