COVID-19 reinfection in a healthcare worker after exposure w
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Get authentic, real-time news that helps you fight COVID-19 better.
Install PlexusMD App for doctors. It's free.
Reinfection with COVID-19 is possible after exposure to a high dose of the virus. Due to immunity acquired during the previous infection, light symptoms are expected. The finding indicates importance of continuous protection in healthcare workers.

A 36-year-old man in charge of collecting samples at the Corona Diagnosis Center in Tabriz, Iran, was evaluated for symptoms of lethargy and fatigue. On day 3 after symptom onset, he was tested positive for SARS-CoV-2 by qualitative real-time reverse transcriptase-polymerase chain reaction assay (qRT-PCR) of the ORF1N gene (BioGerm) in nasopharyngeal swab according to WHO interim guidance.

The patient did not report any underlying medical conditions such as diabetes, hypertension, or cardiovascular disease. CT scan showed mild pulmonary congestion. Also, he had CRP positive and blood changes such as lymphocyte depletion were observed. Two days later, he presented more severe shortness of breath, headache, fever, and chills. The patient was prescribed azithromycin and naproxen. Five days after the onset of the disease, a mild sore throat with occasional dry coughs was added to the previous symptoms. All symptoms disappeared completely and after which the patient recovered. On the fourteenth day, RT-PCR was retested with a negative result.

On August 25, when sampling a patient, coughing droplets sprayed on the face and eyes of this healthcare worker and caused redness, inflammation, and eye infection (Figure 1). The patient uses chloramphenicol drops and artificial tears, but after 4 days there was no change in redness and inflammation of the eye. On the fourth day, sampling of the eye and nasopharyngeal was performed and this time the result of RT-PCR was positive for both ORF1ab and N. High viral load was also reported in the patient's eye.

From August 29, symptoms began, including fatigue, fever, shortness of breath, and muscle pain in the femur and lower back. But all of these symptoms were much milder than the first episode of the disease. This time, there was no change in the patient's lymphocyte and neutrophil count, and the lymphocyte count was 36%, but the CRP was double positive. The patient was treated with azithromycin, acetaminophen, baclofen, gabapentin, and fluorometholone eye drops, and after about 10 days, he recovered.