Symptomatic reinfection with COVID-19: A case-report study in Iran

Tofigh Yaghubi Kalurazi, Ehsan Amini-Salehi, Samira Rahimi-Shamami, Rahmat Poursmail, Farahnaz Joukar, Soheil Hassanipour, Fariborz Mansour-Ghanaei


Coronavirus disease 2019 (COVID-19) resulted in a worldwide concern. The role of the immunity system and memory cells in this disease and their ability in preventing a secondary infection is a controversial issue. Here we presented a case of reinfection with this virus eight months after the first episode. A twenty-one-year-old man was referred to our local hospital on 19 February 2020 with symptoms of viral infection. COVID-19 infection was confirmed by RT-PCR. He got hospitalized for 5 days. Eight months later on 4 October 2020, he was again referred with symptoms of viral infection and para-clinical tests confirmed COVID-19 infection. He got hospitalized for 6 days in the second episode. Although the immunity system plays important role in COVID-19 infection through the presence of memory cells it doesn’t guarantee permanent immunity to this virus. Reinfection with COVID-19 is possible and has been reported in some other studies. 


COVID-19; Immunity system; SARS-CoV2; Reinfection; Secondary infection


Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 382(8):727-33.

WHO Coronavirus (COVID-19) Dashboard. Available from:

Iwasaki A. What reinfections mean for COVID-19. Lancet Infect Dis. 2021; 21(1):3-5.

Chowdhury MA, Hossain N, Kashem MA, Shahid MA, Alam A. Immune response in COVID-19: A review. J Infect Public Health. 2020; 13(11):1619-29.

Rodda LB, Netland J, Shehata L, Pruner KB, Morawski PA, Thouvenel CD, et al. Functional SARS-CoV-2-Specific Immune Memory Persists after Mild COVID-19. Cell. 2021; 184(1):169-83.e17.

Cañete PF, Vinuesa CG. COVID-19 Makes B Cells Forget, but T Cells Remember. Cell. 2020; 183(1):13-5.

Cox RJ, Brokstad KA. Not just antibodies: B cells and T cells mediate immunity to COVID-19. Nat Rev Immunol. 2020; 20(10):581-2.

Kirkcaldy RD, King BA, Brooks JT. COVID-19 and Postinfection Immunity: Limited Evidence, Many Remaining Questions. Jama. 2020; 323(22):2245-6.

World Health Organization. "Immunity passports" in the context of COVID-19. Available from:

Roy S. COVID-19 Reinfection: Myth or Truth? SN Compr Clin Med. 2020; 2(6):710-3.

Selvaraj V, Herman K, Dapaah-Afriyie K. Severe, Symptomatic Reinfection in a Patient with COVID-19. R I Med J (2013). 2020; 103(10):24-6.

Prado-Vivar B, Becerra-Wong M, Guadalupe JJ, Márquez S, Gutierrez B, Rojas-Silva P, et al. A case of SARS-CoV-2 reinfection in Ecuador. Lancet Infect Dis. 2021; 21(6):e142.

Callow KA, Parry HF, Sergeant M, Tyrrell DA. The time course of the immune response to experimental coronavirus infection of man. Epidemiol Infect. 1990; 105(2):435-46.

Chang SC, Wang JT, Huang LM, Chen YC, Fang CT, Sheng WH, et al. Longitudinal analysis of Severe Acute Respiratory Syndrome (SARS) coronavirus-specific antibody in SARS patients. Clin Diagn Lab Immunol. 2005; 12(12):1455-7.

Huang AT, Garcia-Carreras B, Hitchings MDT, Yang B. A systematic review of antibody mediated immunity to coronaviruses: kinetics, correlates of protection, and association with severity. Nat Commun. 2020; 11(1):4704.

Mo H, Zeng G, Ren X, Li H, Ke C, Tan Y, et al. Longitudinal profile of antibodies against SARS-coronavirus in SARS patients and their clinical significance. Respirology. 2006; 11(1):49-53.

Wu LP, Wang NC, Chang YH, Tian XY, Na DY, Zhang LY, et al. Duration of antibody responses after severe acute respiratory syndrome. Emerg Infect Dis. 2007; 13(10):1562-4.

Van Elslande J, Vermeersch P, Vandervoort K, Wawina-Bokalanga T, Vanmechelen B, Wollants E, et al. Symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection by a Phylogenetically Distinct Strain. Clin Infect Dis. 2021; 73(2):354-6.

Tillett RL, Sevinsky JR, Hartley PD, Kerwin H, Crawford N, Gorzalski A, et al. Genomic evidence for reinfection with SARS-CoV-2: a case study. Lancet Infect Dis. 2021; 21(1):52-8.

Liu W, Tao ZW, Wang L, Yuan ML, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl). 2020; 133(9):1032-8.

Shekhar S, Hannah-Shmouni F. Hookah smoking and COVID-19: call for action. Cmaj. 2020; 192(17):E462.

Marshall JS, Warrington R, Watson W, Kim HL. An introduction to immunology and immunopathology. Allergy Asthma Clin Immunol. 2018; 14(Suppl 2):49.

Ratajczak W, Niedźwiedzka-Rystwej P, Tokarz-Deptuła B, Deptuła W. Immunological memory cells. Cent Eur J Immunol. 2018; 43(2):194-203.

Guallar MP, Meiriño R, Donat-Vargas C, Corral O, Jouvé N, Soriano V. Inoculum at the time of SARS-CoV-2 exposure and risk of disease severity. Int J Infect Dis. 2020; 97:290-2.

Kumar A, Prasoon P. SARS-CoV-2-specific virulence factors in COVID-19. J Med Virol. 2021; 93(3):1343-50.

Tavakolpour S, Rakhshandehroo T, Wei EX, Rashidian M. Lymphopenia during the COVID-19 infection: What it shows and what can be learned. Immunol Lett. 2020; 225:31-2.

Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020; 5(1):33.

Knight JC. Genomic modulators of the immune response. Trends Genet. 2013; 29(2):74-83.

Aguirre-Gamboa R, Joosten I, Urbano PCM, van der Molen RG, van Rijssen E, van Cranenbroek B, et al. Differential Effects of Environmental and Genetic Factors on T and B Cell Immune Traits. Cell Rep. 2016; 17(9):2474-87.

Ellinghaus D, Degenhardt F, Bujanda L, Buti M, Albillos A, Invernizzi P, et al. Genomewide Association Study of Severe Covid-19 with Respiratory Failure. N Engl J Med. 2020; 383(16):1522-34.

Dietert RR, Golemboski KA, Austic RE. Environment-immune interactions. Poult Sci. 1994; 73(7):1062-76.



  • There are currently no refbacks.

Copyright (c) 2022 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.