Abstract
Purpose: Several cases of symptomatic reinfection with SARS-CoV-2 after
full recovery from a prior episode have been reported. While an uncommon
phenomenon, an improved understanding of the risk factors for
reinfection and the character and duration of the serological responses
to infection and vaccination is critical for managing the COVID-19
pandemic. Methods: We described four cases of SARS CoV-2 reinfection in
individuals representing a spectrum of healthy and immunocompromised
states, including 1) a healthy 41-year-old pediatrician, 2) an
immunocompromised 31-year-old with granulomatosis with polyangiitis, 3)
a healthy 26-year-old pregnant woman, and 4) a 50-year-old with
hypertension and hyperlipidemia. We performed confirmatory quantitative
RT-PCR and qualitative IgM and quantitative IgG testing on all available
patient samples to confirm the presence of infection and serological
response to infection. Results: Our analysis showed that patients 1 and
2, a healthy and an immunocompromised patient, both failed to mount a
robust serologic response to initial infection. In contrast, patient 3
and 4, with minimal comorbid disease, both mounted a strong serological
response to their initial infection but were still susceptible to
reinfection. Conclusion: Repeat episodes of COVID-19 seem capable of
occurring to patients regardless of the presence of known risk factors
for infection or level of serological response to infection, although
this did not trigger critical illness in any instance.