PMC9355687_01
Timeline of reinfection case. Image was created with BioRender.com.
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F1
A summary reinfection case timeline is presented in Figure 1.
(A) Serial serology of SARS-CoV-2 IgG (blue) and neutralizing antibody (green). Image was created with GraphPad Prism 9.3.1 and BioRender.com, (B) phylogenetic analysis of SARS-CoV-2 genomes showing the relationship between the two distinct variants of two infection episodes. The tree was constructed by maximum likelihood method. Clade information as inferred by GISAID, Nextstrain, and Pangolin nomenclatures, are shown. The reference genome Wuhan-Hu-1 (GenBank accession number NC_045512.2) is used as the root of the tree.
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F2
Subsequent serological testing was performed at several timepoints after the initial COVID-19 episode (Figure 2A), with a peak S-RBD IgG index of 998.4 U/mL and a peak sVNT value of 88% on February 17. T478K, D614G, P681R, and D950N) that were consistent with the Delta variant, belonging to Pango Lineage B.1.617.2 or clade 21A on Nextstrain. Genomic analysis showed that the first episode viral genome belonged to a different clade/lineage from the second viral genome (Figure 2B). The patient underwent self-isolation at home and received treatment with vitamins, oseltamivir, paracetamol, and candesartan.