Recurrent SARS-CoV-2 Infection: Case Reports and Review of the Literature

Abstract

We describe a 37-year-old woman who became infected with SARS-CoV-2. Over time, 4 other members in her family unit became infected, with 3/5 developing 2-3 separate clinical syndromes over two months. It is possible that each person had a single prolonged infection, with the literature reporting RNA detection for as long as 83 days in some cases. Syndromes of relapsing/remitting infection have also been well described. Intermittent negative RNA readings may represent “false negative” results with intermittent levels of viremia that occasionally fall below the limit of detection of the assay. An alternative explanation may be multiple episodes of infection, clearance, and re-infection within the family unit. Preliminary reports in the literature suggest onward transmission after recurrent infection in 3 reported cases. An understanding of the prevalence of cases series such as ours and their pathophysiologic and immunologic significance will improve our knowledge about SARS-CoV-2 infection and strategies to control it.