How can you Distinguish Between COVID-19 and its Reinfection?

The majority Of COVID-19 cases show the persistence of antibodies for at least 6 months post-recovery. . However, reinfection has also be observed in many individuals across all age groups. Further, the severity of the infection was also found to vary across cases. Regarding SARS-CoV-2 reinfection cases, not many studies are available on viral characteristics, degree of sequence heterogeneity, and the point of mutation. One of the most challenging tasks of physicians has been differentiating between persistent COVID-19 and SARS-CoV-2 reinfection. Recently, a team of researchers analyzed SARS-CoV-2 sequences from the publicly available reports on reinfection and persistence. This study was published on a preprint server. Researchers performed a systematic literature review. hey included both peer-reviewed and preprint reports. To review the literature and report search results, they have used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). They also included nasopharyngeal or anterior nasal sequences in their study. Platforms such as NextClade and snp-sites were utilized to obtain and analyze sequences required for studying mutations. The researchers determined that rare mutations or polymorphisms were present in the reinfecting sequence and not the initial variant. The current study has revealed that, in general, two factors can be used to differentiate reinfection from persistence. These are,

  1. Reinfections have been mostly associated with immunocompetent individuals. However, the majority of persistent SARS-CoV-2 infection cases have been reported in immunosuppressed patients.

  2. Phylogenetic analysis can generally differentiate between reinfection and persistence. However, slow evolution rate, limited viral diversity, limited sampling, and varying durations between samples prevent differentiating between reinfection and persistent infection using phylogenetic study.

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