A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia
Abstract Background Since its emergence in November 2021, SARS-CoV-2 Omicron clade has quickly become dominant, due to its increased transmissibility and immune evasion. Different sublineages are currently circulating, which differ in mutations and deletions in regions of the SARS-CoV-2 genome impli...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08111-4 |
| _version_ | 1827635467646926848 |
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| author | Rossana Scutari Valeria Fox Maria Antonietta De Ioris Vanessa Fini Annarita Granaglia Valentino Costabile Luna Colagrossi Cristina Russo Angela Mastronuzzi Franco Locatelli Carlo Federico Perno Claudia Alteri |
| author_facet | Rossana Scutari Valeria Fox Maria Antonietta De Ioris Vanessa Fini Annarita Granaglia Valentino Costabile Luna Colagrossi Cristina Russo Angela Mastronuzzi Franco Locatelli Carlo Federico Perno Claudia Alteri |
| author_sort | Rossana Scutari |
| collection | DOAJ |
| description | Abstract Background Since its emergence in November 2021, SARS-CoV-2 Omicron clade has quickly become dominant, due to its increased transmissibility and immune evasion. Different sublineages are currently circulating, which differ in mutations and deletions in regions of the SARS-CoV-2 genome implicated in the immune response. In May 2022, BA.1 and BA.2 were the most prevalent sublineages in Europe, both characterized by ability of evading natural acquired and vaccine-induced immunity and of escaping monoclonal antibodies neutralization. Case presentation A 5-years old male affected by B-cell acute lymphoblastic leukemia in reinduction was tested positive for SARS-CoV-2 by RT-PCR at the Bambino Gesù Children Hospital in Rome in December 2021. He experienced a mild COVID-19 manifestation, and a peak of nasopharyngeal viral load corresponding to 15.5 Ct. Whole genome sequencing identified the clade 21 K (Omicron), sublineage BA.1.1. The patient was monitored over time and tested negative for SARS-CoV-2 after 30 days. Anti-S antibodies were detected positive with modest titre (3.86 BAU/mL), while anti-N antibodies were negative. 74 days after the onset of the first infection and 23 days after the last negative test, the patient was readmitted to hospital with fever, and tested positive for SARS-CoV-2 by RT-PCR (peak of viral load corresponding to 23.3 Ct). Again, he experienced a mild COVID-19. Whole genome sequencing revealed an infection with the Omicron lineage BA.2 (21L clade). Sotrovimab administration was started at the fifth day of positivity, and RT-PCR negativity occurred 10 days later. Surveillance SARS-CoV-2 RT-PCR were persistently negative, and in May 2022, anti-N antibodies were found positive and anti-S antibodies reached titres > 5000 BAU/mL. Conclusions By this clinical case, we showed that SARS-CoV-2 reinfection within the Omicron clade can occur and can be correlated to inadequate immune responses to primary infection. We also showed that the infection’s length was shorter in the second respect to first episode, suggesting that pre-existing T cell-mediated immunity, though not preventing re-infection, might have limited the SARS-CoV-2 replication capacity. Lastly, Sotrovimab treatment retained activity against BA.2, probably accelerating the viral clearance in the second infectious episode, after which seroconversion and increase of anti-S antibodies titres were observed. |
| first_indexed | 2024-03-09T15:27:06Z |
| format | Article |
| id | doaj.art-3f71f308a4294cc8a2747efdbbc8331b |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T15:27:06Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-3f71f308a4294cc8a2747efdbbc8331b2023-11-26T12:27:22ZengBMCBMC Infectious Diseases1471-23342023-03-012311610.1186/s12879-023-08111-4A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemiaRossana Scutari0Valeria Fox1Maria Antonietta De Ioris2Vanessa Fini3Annarita Granaglia4Valentino Costabile5Luna Colagrossi6Cristina Russo7Angela Mastronuzzi8Franco Locatelli9Carlo Federico Perno10Claudia Alteri11Department of Oncology and Hemato-Oncology, University of MilanDepartment of Oncology and Hemato-Oncology, University of MilanDepartment of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children’s Hospital IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSDepartment of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children’s Hospital IRCCSDepartment of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children’s Hospital IRCCSMultimodal Research Area, Unit of Microbiology and Diagnostics in Immunology, Bambino Gesù Children’s Hospital, IRCCSDepartment of Oncology and Hemato-Oncology, University of MilanAbstract Background Since its emergence in November 2021, SARS-CoV-2 Omicron clade has quickly become dominant, due to its increased transmissibility and immune evasion. Different sublineages are currently circulating, which differ in mutations and deletions in regions of the SARS-CoV-2 genome implicated in the immune response. In May 2022, BA.1 and BA.2 were the most prevalent sublineages in Europe, both characterized by ability of evading natural acquired and vaccine-induced immunity and of escaping monoclonal antibodies neutralization. Case presentation A 5-years old male affected by B-cell acute lymphoblastic leukemia in reinduction was tested positive for SARS-CoV-2 by RT-PCR at the Bambino Gesù Children Hospital in Rome in December 2021. He experienced a mild COVID-19 manifestation, and a peak of nasopharyngeal viral load corresponding to 15.5 Ct. Whole genome sequencing identified the clade 21 K (Omicron), sublineage BA.1.1. The patient was monitored over time and tested negative for SARS-CoV-2 after 30 days. Anti-S antibodies were detected positive with modest titre (3.86 BAU/mL), while anti-N antibodies were negative. 74 days after the onset of the first infection and 23 days after the last negative test, the patient was readmitted to hospital with fever, and tested positive for SARS-CoV-2 by RT-PCR (peak of viral load corresponding to 23.3 Ct). Again, he experienced a mild COVID-19. Whole genome sequencing revealed an infection with the Omicron lineage BA.2 (21L clade). Sotrovimab administration was started at the fifth day of positivity, and RT-PCR negativity occurred 10 days later. Surveillance SARS-CoV-2 RT-PCR were persistently negative, and in May 2022, anti-N antibodies were found positive and anti-S antibodies reached titres > 5000 BAU/mL. Conclusions By this clinical case, we showed that SARS-CoV-2 reinfection within the Omicron clade can occur and can be correlated to inadequate immune responses to primary infection. We also showed that the infection’s length was shorter in the second respect to first episode, suggesting that pre-existing T cell-mediated immunity, though not preventing re-infection, might have limited the SARS-CoV-2 replication capacity. Lastly, Sotrovimab treatment retained activity against BA.2, probably accelerating the viral clearance in the second infectious episode, after which seroconversion and increase of anti-S antibodies titres were observed.https://doi.org/10.1186/s12879-023-08111-4Omicron reinfection case reportBA.1BA.2SARS-CoV-2Immunocompromised paediatric patient |
| spellingShingle | Rossana Scutari Valeria Fox Maria Antonietta De Ioris Vanessa Fini Annarita Granaglia Valentino Costabile Luna Colagrossi Cristina Russo Angela Mastronuzzi Franco Locatelli Carlo Federico Perno Claudia Alteri A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia BMC Infectious Diseases Omicron reinfection case report BA.1 BA.2 SARS-CoV-2 Immunocompromised paediatric patient |
| title | A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia |
| title_full | A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia |
| title_fullStr | A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia |
| title_full_unstemmed | A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia |
| title_short | A case of SARS-CoV-2 Omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by B-cell acute lymphoblastic leukemia |
| title_sort | case of sars cov 2 omicron reinfection resulting in a significant immunity boost in a paediatric patient affected by b cell acute lymphoblastic leukemia |
| topic | Omicron reinfection case report BA.1 BA.2 SARS-CoV-2 Immunocompromised paediatric patient |
| url | https://doi.org/10.1186/s12879-023-08111-4 |
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