Genomic Evidence of SARS-CoV-2 Reinfection Involving E484K Spike Mutation, Brazil

Abstract

Uncertainty remains about how long the protective immune responses against severe acute respiratory syndrome coronavirus 2 persists, and suspected reinfection in recovered patients has been reported. We describe a case of reinfection from distinct virus lineages in Brazil harboring the E484K mutation, a variant associated with escape from neutralizing antibodies.

Keywords: Brazil; COVID-19; E484K spike mutation; SARS-CoV-2; coronavirus disease; genomic surveillance; reinfection; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses.

Figure

Molecular characterization of a severe acute respiratory syndrome coronavirus 2 reinfection case in Salvador, Bahia State, northeast Brazil. A) Timeline of symptom onset and molecular and serologic diagnosis. B) Time-scaled maximum-likelihood tree, including the new genomes (GISAID accession nos. EPI_ISL_756293 and EPI_ISL_756294; https://www.gisaid.org) recovered from a 45-year-old woman residing in Salvador and full-length viral genomes from Brazil available through GISAID as of January 14, 2021 (Appendix Table, https://wwwnc.cdc.gov/EID/article/27/5/21-0191-App1.xlsx). New genomes are highlighted with red circles. Branch support (SH-aLTR >0.8) is shown at key nodes. C) Mutational pattern of the 2 isolates obtained from the same patient within a 147-day interval. Only unique mutations and lineage defining mutations for B.1.1.33 and P.2 are shown. ORF, open reading frame; rRT-PCR, real-time reverse transcription PCR; UTR, untranslated region.