Working Paper Case Report Version 2 This version is not peer-reviewed

Genomic Evidence of a SARS-CoV-2 Reinfection Case with E484K Spike Mutation in Brazil

Version 1 : Received: 5 January 2021 / Approved: 6 January 2021 / Online: 6 January 2021 (20:38:36 CET)
Version 2 : Received: 26 January 2021 / Approved: 27 January 2021 / Online: 27 January 2021 (15:08:12 CET)

How to cite: Vasques Nonaka, C.K.; Miranda Franco, M.; Gräf, T.; Almeida Mendes, A.V.; Santana de Aguiar, R.; Giovanetti, M.; Solano de Freitas Souza, B. Genomic Evidence of a SARS-CoV-2 Reinfection Case with E484K Spike Mutation in Brazil. Preprints 2021, 2021010132 Vasques Nonaka, C.K.; Miranda Franco, M.; Gräf, T.; Almeida Mendes, A.V.; Santana de Aguiar, R.; Giovanetti, M.; Solano de Freitas Souza, B. Genomic Evidence of a SARS-CoV-2 Reinfection Case with E484K Spike Mutation in Brazil. Preprints 2021, 2021010132

Abstract

To date, uncertainty remains about how long the protective immune responses against SARS-CoV-2 persists and reports of suspected reinfection began to be described in recovered patients months after the first episode. Viral evolution may favor reinfections, and the recently described spike mutations, particularly in the receptor binding domain (RBD) in SARS-CoV-2 lineages circulating in the UK, South Africa, and most recently in Brazil, have raised concern on their potential impact in infectivity, immune escape and reinfection. We report a case of reinfection from distinct SARS-CoV-2 lineages presenting the E484K mutation in Brazil, a variant associated with escape from neutralizing antibodies.

Subject Areas

SARS-CoV-2; reinfection; E484K

Comments (1)

Comment 1
Received: 27 January 2021
Commenter: Marta Giovanetti
Commenter's Conflict of Interests: Author
Comment: Phylogenetic analysis, of the two newly whole genome sequences compared with contemporaneous sequences from Brazil (Supplementary Table 1), clearly demonstrated that the two COVID-19 episodes, separated by a 147-day interval, were indeed caused by different SARS-CoV-2 lineages, confirming reinfection (Figure 1B). In the first episode, the lineage B.1.1.33 was detected, whereas lineage P.2 (an alias for B.1.1.28.2) was detected in the second infection (Figure 1 panel B), according to the Pangolin lineage classification (pangoLEARN version 2021-01-11).  Further, we identified several mutations distinguishing the two genomes (Figure 1C), three of them in the SARS-CoV-2 spike glycoprotein. In the first infection, the retrieved genome presented the S:G1219C, while in the second infection, S:E484K and S:V1176F were observed.
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