PMC8075619_01
The context of the two episodes of SARS-CoV-2 infection: A) Time line of
the COVID-19 first and second episodes; B) Cumulative number of cases in
Araraquara city from August, 2020 to March, 2021. Red arrows correspond to
the patient's COVID-19 episodes. The dotted line highlights the first
detection of the P.1 lineage in Araraquara city; C) Description of the
symptoms reported by the patient during the first and the second
episodes.
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In the first infection episode, the patient sought the public health system for COVID-19 testing on September 29, 2020 (Figure 1A). The patient reported symptoms consistent with COVID-19 (Figure 1A and 1C) since September 25, 2020, and reported that her husband tested positive for SARS-CoV-2 by real-time quantitative reverse transcription-polymerase chain reaction (RT-qPCR) six days before. Then, in early February, 2021, she reported similar symptoms described in the COVID-19 episode in September 2020 with joint pain in the right leg in addition to difficulty breathing (Figure 1C). SARS-CoV-2 RNA detection in a nasopharyngeal swab sample by RT-qPCR (Figure 1A). Similar to the previous SARS-CoV-2 episode, she presented only with mild symptoms and hospitalization was again not required.
Maximum Likelihood (ML) phylogenetic tree of 38 complete genomes from P.1
and B.1.1.28 SARS-CoV-2. The isolate of the patient from Araraquara city
corresponding to the second infection (red dot) clustered within the well
supported clade of P.1 viruses from Manaus, Araraquara and Sao Paulo (blue
dots) retrieved from GISAID. Viruses belonging to the B.1.1.28 parent
lineage are represented by dark red dots.
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Araraquara and Sao Paulo city) and the parent lineage B.1.1.28. According to the ML tree, the virus from the second infection of this case report clustered within a monophyletic cluster of P.1 viruses (Figure 2).