lancet-header

Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.

SARS-CoV-2 Reinfections in Denmark Confirmed by Whole Genome Sequencing

24 Pages Posted: 10 Mar 2022

See all articles by Daniela Michlmayr

Daniela Michlmayr

Statens Serum Institut - Department of Bacteria, Parasites and Fungi

Michael Asger Andersen

Statens Serum Institut - Department of Data Management and Analysis

Marianna Meaidi

Statens Serum Institut - Department of Data Management and Analysis

Irfatha Irshad

Statens Serum Institut - Department of Data Management and Analysis

Luís Alves de Sousa

Statens Serum Institut - Infectious Disease Epidemiology & Prevention

Jannik Fonager

Statens Serum Institut - Virus Research & Development Laboratory

Morten Rasmussen

Statens Serum Institut - Virus Research & Development Laboratory

Sophie Madeleine Gubbels

Statens Serum Institut - Department of Data Management and Analysis

Lasse Dam Rasmussen

Statens Serum Institut - Virus Research & Development Laboratory

More...

Abstract

Background: It is unclear how often reinfections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occur. The aim of this study is to identify reinfections in the Danish population by real-time reverse transcription polymerase chain reaction (RT-PCR) and whole genome sequencing (WGS).

Methods: In this population-based retrospective study, we analyzed approximately 19 million real-time RT-PCR tests from 4·4 million individuals between March 202 and March 2021 as part of Denmark’s SARS-CoV-2 surveillance system. Suspected reinfection cases were defined as individuals with two or more SARS-CoV-2 PCR positive tests and > than 60 days between the two tests and confirmed by WGS analysis. Additionally, WGS confirmed reinfection cases with less than 60 days between first and second infection were also included in this study.

Findings: Based on real-time RT- PCR positive results we identified 593 suspected reinfection cases, and 15 WGS confirmed reinfection cases within the Danish population. In nine persons, confirmed reinfections occurred within 60 days after the first SARS-CoV-2 positive test. A unique set of amino acid changes occurred within the S protein sequence of SARS-CoV-2 isolated from first and second infection samples from each confirmed reinfection case.

Interpretation: Most reinfections occurred before the recommended 60-90 day threshold between the first and second episode of infection and we suggest to re-examine the case definition for reinfection cases for SARS-CoV-2.  This may have important implications for intervention measures to control the ongoing pandemic and allows us gain a better understanding of natural immunity to SARS-CoV-2.

Funding Information: Daniela Michlmayr was supported by the European Programme for Public Health Microbiology (EUPHEM), European Centre for Disease Prevention and Control, (ECDC).

Declaration of Interests: The authors declare no conflict of interest.

Ethics Approval Statement: Our analyses are based on existing Danish national Covid-19 surveillance data and did not require ethical approval.

Keywords: SARS-CoV-2, Reinfection, comorbidities, Whole genome sequencing, Denmark

Suggested Citation

Michlmayr, Daniela and Andersen, Michael Asger and Meaidi, Marianna and Irshad, Irfatha and de Sousa, Luís Alves and Fonager, Jannik and Rasmussen, Morten and Gubbels, Sophie Madeleine and Rasmussen, Lasse Dam, SARS-CoV-2 Reinfections in Denmark Confirmed by Whole Genome Sequencing. Available at SSRN: https://ssrn.com/abstract=4054457 or http://dx.doi.org/10.2139/ssrn.4054457

Daniela Michlmayr

Statens Serum Institut - Department of Bacteria, Parasites and Fungi

Copenhagen
Denmark

Michael Asger Andersen

Statens Serum Institut - Department of Data Management and Analysis ( email )

Copenhagen
Denmark

Marianna Meaidi

Statens Serum Institut - Department of Data Management and Analysis ( email )

Copenhagen
Denmark

Irfatha Irshad

Statens Serum Institut - Department of Data Management and Analysis ( email )

Copenhagen
Denmark

Luís Alves De Sousa

Statens Serum Institut - Infectious Disease Epidemiology & Prevention ( email )

Copenhagen
Denmark

Jannik Fonager

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Copenhagen
Denmark

Morten Rasmussen

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Copenhagen
Denmark

Sophie Madeleine Gubbels

Statens Serum Institut - Department of Data Management and Analysis ( email )

Copenhagen
Denmark

Lasse Dam Rasmussen (Contact Author)

Statens Serum Institut - Virus Research & Development Laboratory ( email )

Copenhagen
Denmark

Click here to go to TheLancet.com

Paper statistics

Abstract Views
869
Downloads
124
PlumX Metrics