Two prolonged viremic SARS-CoV-2 infections with conserved viral genome for two months

doi:10.1016/j.meegid.2020.104684

Case Reports

. 2021 Mar:88:104684.

doi: 10.1016/j.meegid.2020.104684. Epub 2020 Dec 24.

Two prolonged viremic SARS-CoV-2 infections with conserved viral genome for two months

Laith J Abu-Raddad¹, Hiam Chemaitelly², Joel A Malek³, Ayeda A Ahmed⁴, Yasmin A Mohamoud⁴, Shameem Younuskunju⁴, Zaina Al Kanaani⁵, Abdullatif Al Khal⁵, Einas Al Kuwari⁵, Adeel A Butt⁵, Peter Coyle⁵, Andrew Jeremijenko⁵, Anvar Hassan Kaleeckal⁵, Ali Nizar Latif⁵, Riyazuddin Mohammad Shaik⁵, Hanan F Abdul Rahim⁶, Hadi M Yassine⁷, Mohamed G Al Kuwari⁸, Hamad Eid Al Romaihi⁹, Mohamed H Al-Thani⁹, Roberto Bertollini⁹

Affiliations

¹ Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, NY, New York, USA. Electronic address: lja2002@qatar-med.cornell.edu.
² Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
³ Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; Department of Genetic Medicine, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁴ Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁵ Hamad Medical Corporation, Doha, Qatar.
⁶ College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
⁷ Biomedical Research Center, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar.
⁸ Primary Health Care Corporation, Doha, Qatar.
⁹ Ministry of Public Health, Doha, Qatar.

PMID: 33352320
PMCID: PMC7759339
DOI: 10.1016/j.meegid.2020.104684

Case Reports

Two prolonged viremic SARS-CoV-2 infections with conserved viral genome for two months

Laith J Abu-Raddad et al. Infect Genet Evol. 2021 Mar.

. 2021 Mar:88:104684.

doi: 10.1016/j.meegid.2020.104684. Epub 2020 Dec 24.

Authors

Affiliations

¹ Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, NY, New York, USA. Electronic address: lja2002@qatar-med.cornell.edu.
² Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
³ Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; Department of Genetic Medicine, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁴ Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁵ Hamad Medical Corporation, Doha, Qatar.
⁶ College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
⁷ Biomedical Research Center, Qatar University, Doha, Qatar; Department of Biomedical Science, College of Health Sciences, Member of QU Health, Qatar University, Doha, Qatar.
⁸ Primary Health Care Corporation, Doha, Qatar.
⁹ Ministry of Public Health, Doha, Qatar.

PMID: 33352320
PMCID: PMC7759339
DOI: 10.1016/j.meegid.2020.104684

Abstract

We document two cases of viremic and prolonged active infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) where the viral genome was conserved for two months, but infection was with little or no symptoms. The first infection persisted for 80 days and the second for 62 days. Clearance of infection occurred 40 and 41 days, respectively, after development of detectable antibodies. Both cases were identified incidentally in an investigation of reinfection in a cohort of 133,266 laboratory-confirmed infected persons.

Keywords: COVID-19; Epidemiology; Genome; Infection; Infectious period; SARS-CoV-2.

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Conflict of interest statement

We declare no competing interests.

Figures

**Fig. 1**
History of SARS-CoV-2 infection in the two prolonged active-infection cases with high viral RNA concentration and conserved viral genome.

**Fig. 2**
Viral genome sequencing analysis of the paired viral specimens of the first and last positive swabs for the two active-infection cases with high viral RNA concentration for two months.

See this image and copyright information in PMC

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References

1. Abu-Raddad L.J., Chemaitelly H., Ayoub H.H., Al Kanaani Z., Al Khal A., Al Kuwari E., Butt A.A., Coyle P., Jeremijenko A., Kaleeckal A.H., Latif A.N., Owen R.C., Abdul Rahim H.F., Al Abdulla S.A., Al Kuwari M.G., Kandy M.C., Saeb H., Ahmed S.N.N., Al Romaihi H.E., Bansal D., Dalton L., Al Thani S.M., Bertollini R. Characterizing the Qatar advanced-phase SARS-CoV-2 epidemic. medRxiv. 2020 doi: 10.1101/2020.07.16.20155317. 2020.2007.2016.20155317v20155312. - DOI - PMC - PubMed
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1. Al Kuwari H.M., Abdul Rahim H.F., Abu-Raddad L.J., Abou-Samra A.-B., Al Kanaani Z., Al Khal A., Al Kuwari E., Al Marri S., Al Masalmani M., Al Romaihi H.E., Al Thani M.H., Coyle P.V., Latif A.N., Owen R., Bertollini R., Butt A.A. Epidemiological investigation of the first 5685 cases of SARS-CoV-2 infection in Qatar, 28 February–18 April 2020. BMJ Open. 2020;10 - PMC - PubMed
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[1] Abu-Raddad L.J., Chemaitelly H., Ayoub H.H., Al Kanaani Z., Al Khal A., Al Kuwari E., Butt A.A., Coyle P., Jeremijenko A., Kaleeckal A.H., Latif A.N., Owen R.C., Abdul Rahim H.F., Al Abdulla S.A., Al Kuwari M.G., Kandy M.C., Saeb H., Ahmed S.N.N., Al Romaihi H.E., Bansal D., Dalton L., Al Thani S.M., Bertollini R. Characterizing the Qatar advanced-phase SARS-CoV-2 epidemic. medRxiv. 2020 doi: 10.1101/2020.07.16.20155317. 2020.2007.2016.20155317v20155312. - DOI - PMC - PubMed

[2] Abu-Raddad L.J., Chemaitelly H., Ayoub H.H., Al Kanaani Z., Al Khal A., Al Kuwari E., Butt A.A., Coyle P., Jeremijenko A., Kaleeckal A.H., Latif A.N., Owen R.C., Abdul Rahim H.F., Al Abdulla S.A., Al Kuwari M.G., Kandy M.C., Saeb H., Ahmed S.N.N., Al Romaihi H.E., Bansal D., Dalton L., Al Thani S.M., Bertollini R. Characterizing the Qatar advanced-phase SARS-CoV-2 epidemic. medRxiv. 2020 doi: 10.1101/2020.07.16.20155317. 2020.2007.2016.20155317v20155312. - DOI - PMC - PubMed

[3] Abu-Raddad L.J., Chemaitelly H., Malek J.A., Ahmed A.A., Mohamoud Y.A., Younuskunju S., Ayoub H.H., Al Kanaani Z., Al Khal A., Al Kuwari E., Butt A.A., Coyle P., Jeremijenko A., Kaleeckal A.H., Latif A.N., Shaik R.M., Abdul Rahim H.F., Yassine H.M., Al Kuwari M.G., Al Romaihi H.E., Al Thani S.M., Bertollini R. Assessment of the risk of SARS-CoV-2 reinfection in an intense re-exposure setting. medRxiv. 2020 doi: 10.1093/cid/ciaa1846. 2020.2008.2024.20179457. - DOI - PMC - PubMed

[4] Abu-Raddad L.J., Chemaitelly H., Malek J.A., Ahmed A.A., Mohamoud Y.A., Younuskunju S., Ayoub H.H., Al Kanaani Z., Al Khal A., Al Kuwari E., Butt A.A., Coyle P., Jeremijenko A., Kaleeckal A.H., Latif A.N., Shaik R.M., Abdul Rahim H.F., Yassine H.M., Al Kuwari M.G., Al Romaihi H.E., Al Thani S.M., Bertollini R. Assessment of the risk of SARS-CoV-2 reinfection in an intense re-exposure setting. medRxiv. 2020 doi: 10.1093/cid/ciaa1846. 2020.2008.2024.20179457. - DOI - PMC - PubMed

[5] Al Kuwari H.M., Abdul Rahim H.F., Abu-Raddad L.J., Abou-Samra A.-B., Al Kanaani Z., Al Khal A., Al Kuwari E., Al Marri S., Al Masalmani M., Al Romaihi H.E., Al Thani M.H., Coyle P.V., Latif A.N., Owen R., Bertollini R., Butt A.A. Epidemiological investigation of the first 5685 cases of SARS-CoV-2 infection in Qatar, 28 February–18 April 2020. BMJ Open. 2020;10 - PMC - PubMed

[6] Al Kuwari H.M., Abdul Rahim H.F., Abu-Raddad L.J., Abou-Samra A.-B., Al Kanaani Z., Al Khal A., Al Kuwari E., Al Marri S., Al Masalmani M., Al Romaihi H.E., Al Thani M.H., Coyle P.V., Latif A.N., Owen R., Bertollini R., Butt A.A. Epidemiological investigation of the first 5685 cases of SARS-CoV-2 infection in Qatar, 28 February–18 April 2020. BMJ Open. 2020;10 - PMC - PubMed

[7] Centers for Disease Control and Prevention . 2020. Symptom-Based Strategy to Discontinue Isolation for Persons with COVID-19. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue.... Accessed on June 2, 2020.

[8] Centers for Disease Control and Prevention . 2020. Symptom-Based Strategy to Discontinue Isolation for Persons with COVID-19. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue.... Accessed on June 2, 2020.

[9] COVID-19 Outbreak Live Update. 2020. Available from: https://www.worldometers.info/coronavirus/. Accessed on September 06, 2020.

[10] COVID-19 Outbreak Live Update. 2020. Available from: https://www.worldometers.info/coronavirus/. Accessed on September 06, 2020.

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Two prolonged viremic SARS-CoV-2 infections with conserved viral genome for two months

Affiliations

Two prolonged viremic SARS-CoV-2 infections with conserved viral genome for two months

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Affiliations

Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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