Recurrent COVID-19 including evidence of reinfection and enhanced severity in thirty Brazilian healthcare workers.

BACKGROUND: There is growing concern about individuals reported to suffer repeat COVID-19 disease episodes, these in a small number of cases characterised as de novo infections with distinct sequences, indicative of insufficient protective immunity even in the short term. METHODS: Observational case series and case-control studies reporting 33 cases of recurrent, symptomatic, qRT-PCR positive COVID-19. Recurrent disease was defined as symptomatic recurrence after symptom-free clinical recovery, with release from isolation >14 days from the beginning of symptoms confirmed by qRT-PCR. The case control study-design compared this group of patients with a control group of 62 patients randomly selected from the same COVID-19 database. RESULTS: Of 33 recurrent COVID-19 patients, 26 were female and 30 were HCW. Mean time to recurrence was 50.5 days which was associated with being a HCW (OR 36.4 (p <0.0001)), and blood type A (OR 4.8 (p = 0.002)). SARS-CoV-2 antibodies were signifcantly lower in recurrent patients after initial COVID-19  (2.4 ±â€¯0.610; p<0.0001) and after recurrence (6.4 ±â€¯11.34; p = 0.007).  Virus genome sequencing identified reinfection by a different isolate in one patient. CONCLUSIONS: This is the first detailed case series showing COVID-19 recurrence with qRT-PCR positivity. For one individual detection of phylogenetically distinct genomic sequences in the first and second episodes confirmed bona fide renfection, but in most cases the data do not formally distinguish between reinfection and re-emergence of a chronic infection reservoir. These episodes were significantly associated with reduced Ab response during initial disease and argue the need for ongoing vigilance without an assumption of protection after a first episode.

Phytochemical and pharmacological study of Sedum dendroideum leaf juice.

The fresh juice from leaves of Sedum dendroideum Moc & Sessé (Crassulaceae) is used in Brazilian traditional medicine for the treatment of gastric and inflammatory disorders. The present investigation was carried out to evaluate in vivo antinociceptive and anti-inflammatory activities of this plant material. The oral administration (0.1-1g/kg) of the lyophilized Sedum dendroideum juice (L J) caused a significant dose-related reduction of acetic acid-induced writhing response (ID(50)=631 mg/kg) and inhibited croton oil-induced ear oedema formation (66% inhibition at 1g/kg) in mice. In the formalin-induced nociception in mice, L J (1g/kg) only inhibited the second phase of nociception (46%). Phytochemical investigation revealed four known kaempferol glycosides, here, described at the first time for this species. These flavonoids probably explain the antinociceptive and anti-inflammatory effects of the fresh juice of Sedum dendroideum.