Table 1.
Characteristics of the included studies (a) Part 1 and (b) Part 2
| Study | Country | Study type | Reinfected patients (gender, age) | Reinfected patients/re-positive patients | Time between episodes (days, month) | Clinical symptoms# | |
|---|---|---|---|---|---|---|---|
| 1st episode | 2nd episode | ||||||
| (a) Part 1 | |||||||
| To et al. [8] | China | Case report | M, 33 | – | 142d | Cough and sputum, sore throat, fever and headache | Asymptomatic |
| Tillett et al. [9] | United States | Case report | M, 25 | – | 65d | Sore throat, cough, headache, nausea, and diarrhoea | Myalgia, cough, and shortness of breath |
| Borgogna et al. [10] | Italy | Case report | M, 52 | – | – | Cough and fever | – |
| Gupta et al. [31] | India | Case report | M, 25 (HCW) | – | 108d | Asymptomatic | Asymptomatic |
| F,28 (HCW) | – | 111d | Asymptomatic | Asymptomatic | |||
| Larson et al. [32] | United States | Case report | M, 42 | – | 51d | Cough, subjective fever, and myalgia | Fevers, cough, shortness of breath and gastrointestinal symptoms |
| Staub et al. [33] | Luxembourg | Case report | M, 20s (HCW) | – | 4m | Loss of smell and taste | Cough |
| F, 20s (HCW) | – | 11m | Fever, headache, chills, diarrhoea, loss of taste and smell | Fever, chills, and headache | |||
| M, 30s (HCW) | – | 20d | Asymptomatic | Chills, myalgia, and headache | |||
| F, 20s (HCW) | – | 4m | Fever, muscle pain, headache, loss of taste and smell | Muscle pain and cough | |||
| Salehi-Vaziri et al. [34] | Iran | Case report | F, 32 | – | 63d | Headache, sore throat, cough, fever | Severe cough, fever, fatigue (severe) |
| M, 54 | 156d | Fatigue, anxiety, chest pain, cough, fever | Milder fatigue, chest pain, dizziness, diarrhea(less) | ||||
| M, 42 | 111d | Shortness of breath, sore throat, shaking chills, pain, diarrhea | Similar to the first infection with severe diarrhea (similar) | ||||
| Klein et al. [35] | United States | Case report | M, 60–70 (specific age unknown | – | 232d | Fevers, fatigue, and dry cough | Fatigue and nonproductive cough |
| Shastri et al. [36] | India | Case report | M, 27 (HCW) | – | 64d | Sore throat, nasal congestion and rhinitis | Myalgia, fever, non-productive cough, fatigue |
| F, 24 (HCW) | 52d | Sore throat, rhinitis and myalgia | Fever, myalgia, rhinitis, sore throat, non-productive cough and fatigue | ||||
| F, 25 (HCW) | 136d | Fever, myalgia, dry cough. | Fever, myalgia, dry cough, nausea, abdominal pain, breathlessness on exertion. | ||||
| Vetter et al. [37] | Switzerland | Case report | F, 36 | – | 200d | Asthenia and headache | Asthenia, shivering, rhinorrhoea, anosmia, arthralgia, headache and exertional dyspnoea |
| Harrington et al. [38] | United Kingdom | Case report | M, 78 | – | 253d | Mild illness | Shortness of breath, severe hypoxia (severe) |
| Prado-Vivar et al. [39] | Ecuador | Case report | M, 46 | – | 72d | Intense headache and drowsiness | Odynophagia, nasal congestion, fever of 38.5°C, strong back pain, productive cough and dyspnea (severe) |
| Moschetta et al. [40] | Brazil | Case report | F.39 | – | 8m | fever and cough | headache, myalgia, fever, and cough |
| M, 49 | – | 7m | cough with sputum | fever and cough | |||
| Scarpati et al. [41] | Italy | Case report | M, 63(HCW) | – | – | Asymptomatic | Respiratory failure. fever |
| Massanella et al. [42] | Spain | Case report | M, 62 (HCW) | – | – | fever, diarrhea, anosmia, dysgeusia, cough, intense asthenia, and arthromyalgias | intense arthromyalgias, headache, fever, cough, and dyspnea |
| Garvey et al. [43] | United Kingdom | Case report | M, 92 | – | 206d | Pyrexia, a dry cough and shortness of breath | Lethargy, persistent cough and pyrexia |
| M, 84 | 224d | Lethargy and confusion | Asymptomatic | ||||
| M, 59 | 236d | Cough and fluctuating temperature | Asymptomatic | ||||
| Siqueira et al. [44] | Brazil | Case report | F, 76 | – | 105d | Cough and fever | – |
| Sevillano et al. [45] | Ecuador | Case report | M, 28 | – | 104d | Sore throat, cough, headache, nausea, and diarrhea, anxiety and panic attacks | Anosmia, ageusia, fever, headache |
| Kulkarni et al. [46] | India | Case report | M, 61 | – | 103d | Asymptomatic | Weakness, cough |
| Lee et al. [47] | South Korea | Case report | F, 21 | 1/4 | 32d | Sore throat and cough (mild) | Sore throat and productive cough |
| Fintelman-Rodrigues et al. [48] | Brazil | Case report | M, 54 | – | 65d | Headache | Fever, dry cough, tiredness, body ache, anosmia, ageusia |
| M, 34 | 63d | Asymptomatic | Fever, nausea, tiredness, headache, body ache | ||||
| F, 57 | 61d | Mild diarrhea | Fever, diarrhea, headache, body ache, anosmia, ageusia | ||||
| F, 34 | 60d | Mild diarrhea | Dry cough, diarrhea, tiredness, headache, body ache, anosmia, ageusia | ||||
| Fonseca et al. [49] | Brazil | Case report | M, 29 (HCW) | – | 225d | Fever, myalgia, cough, sore throat, and diarrhea | Fever, myalgia, cough, sore throat, and diarrhea |
| Nonaka et al. [50] | Brazil | Case report | F, 45 (HCW) | – | 147d | Diarrhea, myalgia, asthenia, and onophagia | Headache, malaise, diarrhea, cough, and sore throat that evolved to myalgia and ageusia, muscle fatigue, insomnia, mild dyspnea on exertion, and shortness of breath |
| Ramírez et al. [51] | Colombia | Case report | F, 54 | – | 34d | Cough, fever, odynophagia and fatigue | Fever and odynophagia |
| Alshukairi et al. [52] | Saudi Arabia | Case report | F, 51 | – | 160d | fever, cough, malaise, and headache | progressive fever and dyspnea |
| Aguilar-Shea et al. [53] | Spain | Case report | M, 39 (HCW) | – | 9m | Sore throat, fever, general malaise and nasal congestion, exertional tachycardia and chest pain anosmia and ageusia | Uncomfortable night sleep, sore throat on waking, slight general malaise, nasal congestion and nasal discharge |
| Mulder et al. [54] | Netherlands | Case report | F, 89 | – | 59d | Fever and severe cough | Fever, cough, and dyspnea |
| Dhar et al. [55] | India | Case report | M, 52 | – | 73d | Asymptomatic | Low-grade fever and body ache |
| Goldman et al. [56] | United States | Case report | –, 60–69(specific age unknown) | 1/176 | 140d | Fever, chills, productive cough, dyspnea and chest pain | Dyspnea, dry cough and weakness(less) |
| Marquez et al. [57] | United States | Case report | F, 16 | – | 90d | Sore throat, fatigue, nasal congestion, rhinorrhea, and a nonproductive cough | Leg pain, swelling, fatigue, abdominal tenderness, fever |
| Buddingh et al. [58] | Netherlands | Case report | F, 16 | – | 13m | – | Mild respiratory symptoms |
| Tang et al. [59] | United States | Case report | F, 20s | – | 19d | Cough, chills, exertional dyspnea, sore throat, dizziness, rhinorrhea, fever | Cough, fatigue, and dyspnea |
| Amorim et al. [60] | Brazil | Case report | F, 35 (HCW) | – | 55d | Fever, headache, chills, sneezing, coryza, and myalgia | Headache, nasal congestion, odynophagia, ageusia, and anosmia |
| F, 61 (HCW) | 170d | Headache, cough, myalgia, dysphagy, coryza, diarrhea, and ageusia | Cough, myalgia, odynophagia, anosmia, and diarrhea | ||||
| F, 40 (HCW) | 131d | Nasal congestion, coryza, cough, ageusia | Odynophagia, sneezing, coryza, diarrhea, ageusia, and anosmia | ||||
| F, 40 (HCW) | 148d | Fever, headache, myalgia, coryza, dry cough, vomiting, and malaise | Odynophagia, dry cough, myalgia, malaise, coryza, and headache | ||||
| Novazzi et al. [61] | Italy | Case report | M, 56 | – | 31d | Moderate dyspnea | – |
| M, 58 | 30d | – | – | ||||
| Salehi-Vaziri et al. [62] | Iran | Case report | M, 42 | – | 128d | Cough, headache and severe diarrhea | Body pain, shortness of breath, headache and anosmia |
| Romano et al. [63] | Brazil | Case report | F, 26 | – | 128d | Mild | Joint pain in the right leg, difficulty breathing, tiredness, dizziness and fatigue |
| Camargo et al. [64] | Brazil | Case report | F, 41 | – | – | Headache, disseminated body pain, non-productive cough, shortness of breath, ageusia, and anosmia | Headache, cough, tiredness and myalgia |
| Brehm et al. [65] | Germany | Case report | F, 27 (HCW) | – | 283d | Fever, chills, and exertional dyspnea | Dry cough and mild rhinorrhea |
| Tomkins-Tinch et al. [66] | United States | Case report | M, 61 | – | 111d | Fever, nausea, vomiting, and cough | Asymptomatic |
| Díaz et al. [67] | Panama | Case report | M, 36 | – | 181d | Myalgia, fever, cephalea, and rhinorrhea | Cephalea, myalgia and rhinorrhea |
| Yu et al. [68] | Brazil | Case report | F, 41 (HCW) | – | 146d | Headache, myalgia, fatigue, fever, dry cough, dyspnea, anosmia ageusia | Headache, myalgia, fatigue, fever, dry cough, dyspnea, anosmia and ageusia, diarrhea, anorexia and dizziness |
| F, 34 (HCW) | 173d | Fever, cough, odynophagia and dyspnea | Headache, coryza, fever and sore throat | ||||
| Zucman et al. [69] | France | Case report | M, 58 | – | 129d | Mild fever and dyspnea | Dyspnea and fever |
| Rani et al. [70] | India | Case report | M, 47 | – | 47d | Asymptomatic | Fever, cough, and malaise |
| Loconsole et al. [71] | Italy | Case report | F, 41 (HCW) | – | 293d | Strong arthralgia, low-grade fever, headache, and diarrhea | Sore throat and headache |
| Selhorst et al. [72] | Belgium | Case report | F, 39 (HCW) | – | 185d | Cough, dyspnea, headache, fever and general malaise | Milder |
| Van Elslande et al. [73] | Belgium | Case report | F, 51 | – | 3m | Headache, fever, myalgia, coughing, chest pain and dyspnea, anosmia and a change in taste | Headache, cough and fatigue |
| Jeffery-Smith et al. [74] | United Kingdom | Cross-sectional | – | – | – | Asymptomatic | – |
| Brouqui et al. [75] | France | Cross-sectional |
25M, 21F 50 ± 22 |
46/6771 | 172d(90–308d) |
Mild/moderate 37/39 (94.8); Severe/critical 2/39(5.1); Asymptomatic 7/46 (15.2); |
Mild/moderate 26/33 (78.7); Severe/critical 7/33 (21.2); Asymptomatic 13/46 (28.2); |
| Abu-Raddad et al. [76] | Qatar | Cohort study | M, 35–39 | – | – | Asymptomatic | – |
| F, 40–44 | – | Yes | – | ||||
| F, 35–39 | – | Asymptomatic | – | ||||
| M, 35–39 | – | Asymptomatic | – | ||||
| M, 30–34 | – | Yes | – | ||||
| dos Santos et al. [77] | Brazil | Case–control | M, 44 (HCW) | – | 38d | Mild symptoms | Severe respiratory symptoms |
| Study | Reinfected patients (gender, age) | Lineage and Clade | Ct value | Infectivity | Co-morbidity | Vaccination | Outcome | ||
|---|---|---|---|---|---|---|---|---|---|
| 1st | 2nd | 1st | 2nd | ||||||
| (b) Part 2 | |||||||||
| To et al. [8] | M, 33 | GISAID clade V, B.2, 19A | GISAID clade G, B.1.79, 20A | – | 26.69 | – | None | – | – |
| Tillett et al. [9] | M, 25 | 20C | 20C | – | – | – | None | – | Hospitalized |
| Borgogna et al. [10] | M, 52 | B.1.1, 20B | B.1,20A | 25–26(E, RdRp, and N) | 34(E), 36(RNAseP), > 40 (RdRp) | – | Transitional cell carcinoma of the renal pelvis and ureter | – | Death |
| Gupta et al. [31] | M, 25 (HCW) | – | – | 36 | 16.6 | – | – | – | – |
| F, 28 (HCW) | – | – | 28.16 | 19.62 | – | – | – | – | |
| Larson et al. [32] | M, 42 | B.1.26 | B.1.26 | – | – | – | – | – | – |
| Staub et al. [33] | M, 20s (HCW) | – | B1.351 | – | – | – | – | – | – |
| F, 20s (HCW) | – | B1.351 | – | – | – | – | – | – | |
| M, 30s (HCW) | – | B1.351 | – | – | – | – | – | – | |
| F, 20s (HCW) | – | B1.351 | – | – | – | – | – | – | |
| Salehi-Vaziri et al. [34] | F, 32 | – | – | – | 17(N),18(ORF1ab) | – | None | – | Recovery |
| M, 54 | – | – | 27(N), 29(ORF1ab) | 29(N), 30(ORF1ab) | – | None | – | Recovery | |
| M, 42 | – | – | – | 31(N), 33(ORF) | – | None | – | Recovery | |
| Klein et al. [35] | M, 60–70 (specific age unknown | B.1 | B.1.280 | 17.1(N1); 16.3(N2) | 27.34(N1); 27.15(N2) | – | End-stage renal disease | – | Discharged |
| Shastri et al. [36] | M, 27 (HCW) | B, 20A | B.1.8, 19A | 32(N); 32(ORF1ab) | 25(N); 23(ORF1ab) | – | None | – | – |
| F, 24 (HCW) | B.1, 19A | B.1.1.32, 20B | 32(N); 34(ORF1ab) | 17(N); 18(ORF1ab) | – | None | – | – | |
| F, 25 (HCW) | B.1.5, 19A | B.1, 20A | 31(N); 31(ORF1ab) | 22(N); 22(ORF1ab) | – | Hypertensive | – | – | |
| Vetter et al. [37] | F, 36 | 20A | 20A | – | – | – | – | – | – |
| Harrington et al. [38] | M, 78 | B.2 | B.1.1.7 | 26.8(E); 26.4(ORF1a) | 27.5(E); 27.9(ORF1a) | – | Type 2 diabetes mellitus, diabetic nephropathy, COPD, mixed cenral and obstructive sleep apnea, ischemic heart disease | – | Hospitalized |
| Prado-Vivar et al. [39] | M, 46 |
B1.p9 20A |
A.1.1 19B |
36.85(ORF3a) | – | – | – | – | – |
| Moschetta et al. [40] | F, 39 | – | Gamma VOC | – | – | – | – | CoronaVac COVID-19 vaccine | Recovered |
| M, 49 | – | Gamma VOC | – | – | – | – | first dose of the Astra-Zeneca COVID-19 vaccine | Recovered | |
| Scarpati et al. [41] | M, 63(HCW) | 20A | 20E | – | – | – | Chronic obstructive pulmonary disease (COPD), type II diabetes, atrial fibrillation | first dose of Pfizer vaccination | Hospitalized |
| Massanella et al. [42] | M, 62 (HCW) | – | B.1.79 | – | – | – | mild asthma, hypertension, dyslipidemia, liver steatosis, hyperuricemia, and overweight | – | Discharged |
| Garvey et al. [43] | M, 92 | Sequencing failed | B.1.177 | – | 15.89 | – | Dementia | – | Death |
| M, 84 | Sequencing failed | B.1.177 | – | – | – | Dementia and Paget’s disease | – | – | |
| M, 59 | Sequencing failed | B.1.1.7 | – | – | – | End-stage renal failure | – | – | |
| Siqueira et al. [44] | F, 76 | – | – | 34.21 | 11.99 | Chronic renal failure and pyelonephritis | – | Death | |
| Sevillano et al. [45] | M, 28 |
GISAID clade O, B.1.1 20B |
GISAID clade O, B.1.1 20B |
29.9 | 17.8 | – | – | – | – |
| Kulkarni et al. [46] | M, 61 | 20B | 20B | – | – | – | – | – | – |
| Lee et al. [47] | F, 21 | V | G | 23.11(E); 23.54(RdRP) | 32.36 / 32.79 33.74 / 33.62 | – | – | – | – |
| Fintelman-Rodrigues et al. [48] | M, 54 | Not enough sample | 20B | 26.5 | 24.6 | – | None | – | – |
| M, 34 | 20B | 20B | 27.41 | 28.12 | – | None | – | – | |
| F, 57 | 19A | 20B | 26.66 | 27.06 | – | Discoid lupus erythematosus | – | – | |
| F, 34 | Not enough sample | 20B | 28.48 | 24.5 | – | None | – | – | |
| Fonseca et al. [49] | M, 29 (HCW) | B.1.1.28 | B.1.2 | 15.7(N1), 18.9(N2) | 17.6(N1), 19.6(N2) | – | None | – | – |
| Nonaka et al. [50] | F, 45 (HCW) | B.1.1.33 | B.1.1.28.2 | 25(N); 26(E); 27 (RdRp) | 21(N); 12(E); 17(RdRp) | – | None | – | – |
| Ramírez et al. [51] | F, 54 | B.1 | B.1.1.269 | 21.2 (E); 24.5 (RdRp); 21.7 (N) | 30.6 (E); 32.1(RdRp); 31.9 (N) | – | Hypertension, gastritis, and arthrosis | – | – |
| Alshukairi et al. [52] | F, 51 | A | B.1.1.122 | 3 | 34 | – | follicular non-Hodgkin lymphoma | One dose mRNA COVID-19 vaccine | Discharged |
| Aguilar-Shea et al. [53] | M, 39 (HCW) | – | B.1.1.7 | – | – | – | None | – | Recovery |
| Mulder et al. [54] | F, 89 | – | – | 26.2(E) | 25.2(E) | – | Waldenström macroglobulinemia | – | Death |
| Dhar et al. [55] | M, 52 | B.1.0, 19A | B.1.36.1, 20A | 36.04(ORF1ab); 36.74(E) | 17.9(ORF1ab); 17.8(E) | – | – | – | – |
| Goldman et al. [56] | –, 60–69 (specific age unknown) | 19B | 20A | 22.8 (E); 26.5 (RdRp) | 43.3 (E); 39.6 (N2) | – | Severe emphysema | – | – |
| Marquez et al. [57] | F, 16 | B.1.2 | B.1.1.7 | 32.4(E) 32.0(S) | 30.6(E) 31.0(S) | – | End-stage renal disease | – | – |
| Buddingh et al. [58] | F, 16 | – | B.1.1.7 | – | – | – | Multisystem inflammatory syndrome in children | – | Recovered |
| Tang et al. [59] | F, 20s | A.3 | B.1.1 | 17.76 | 20.36 | – | Asthma, obesity | – | – |
| Amorim et al. [60] | F, 35 (HCW) | B.1.1.33 | B.1.1.28 | 35.24 (E); 40.12(N) | 31.14(E); 31.3(N); 32.58(RdRp) | – | – | – | – |
| F, 61 (HCW) | – | B.1.1.28 | 31.8(E) | 20.45(E); 20.52(N); 22.65(RdRp) | – | – | – | – | |
| F, 40 (HCW) | – | – | 35.15(E) | 26.04(E); 26.88(N); 28.40(RdRp) | – | – | – | – | |
| F,40 (HCW) | – | B.1.1.28 | 34.80(E); 39.86(RdRp) | 23.72(E); 23.48(N); 25.67(RdRp) | – | – | – | – | |
| Novazzi et al. [61] | M, 56 | Wuhan-Hu-1 | B.1.1.7 | – | – | – | Obesity and dyslipidemia | – | Hospitalized |
| M,58 | Wuhan-Hu-1 | B.1.1.7 | – | – | – | None | – | Hospitalized | |
| Salehi-Vaziri et al. [62] | M, 42 | 20G | 20G | 18(N), 19(ORF1ab) | 16(N),17(ORF1ab) | – | – | – | – |
| Romano et al. [63] | F, 26 | Non-VOC virus | VOC virus P.1 | 21 | 24 | – | Rheumatism | – | – |
| Camargo et al. [64] | F, 41 | B.1.1.33 | B.1.1.44 | 18(E),32(RNAseP) | 22(E),30(RNAseP) | None | – | Discharged | |
| Brehm et al. [65] | F, 27 (HCW) | B.3 | B.1.177 | – | – | – | None | – | – |
| Tomkins-Tinch et al. [66] | M, 61 | – | – | – | – | – | Chronic hepatitis B and C | – | Discharged |
| Díaz et al. [67] | M, 36 | A.2.4 | GMI-PA584303 | 19(RdRp) | 27(E), 28(RdRp). | – | None | – | Recovery |
| Yu et al. [68] | F, 41 (HCW) | B.1.1.33 | B.1.1.28 | – | – | – | None | – | – |
| F, 34 (HCW) | B.1.1.28 | P.2 | – | – | – | Chronic respiratory disease | One dose | – | |
| Zucman et al. [69] | M, 58 | – | B.1.351 | – | – | – | Asthma | – | – |
| Rani et al. [70] | M, 47 | B.1.36 | B.1.36 | 22.3(ORF1ab), 19.1(N) | 21.9(ORF1ab), 19.2(N) | – | – | – | – |
| Loconsole et al. [71] | F, 41 (HCW) | B.1.1.74 GISAID clade GR, 20 B | B.1.177GISAID clade GV, 20 E | 30(N);27(ORF1ab); 29(S) | 15(N); 12(ORF1ab); 13(S) | – | None | One dose Comirnaty vaccine (Pfizer-BioNTech) | – |
| Selhorst et al. [72] | F, 39 (HCW) | V | G | Avg Ct 13 | Avg Ct 19 | – | – | – | – |
| Van Elslande et al. [73] | F, 51 | B.1.1 | A |
25.6 (N1) 27.2 (N2) |
32.6 (N1) 33.2 (N2) |
– | Asthma | – | Recovery |
| Jeffery-Smith et al. [74] | – | – | B.1.36 | – | – | – | – | – | – |
| Brouqui et al. [75] |
25M, 21F 50 ± 22 |
– | – | – | – | – | None (20) | – | 2 Death |
| Abu-Raddad et al. [76] | M, 35–39 | – | – | – | – | – | – | – | – |
| F, 40–44 | – | – | – | 22.2 | – | – | – | – | |
| F, 35–39 | – | – | – | – | – | – | – | – | |
| M, 35–39 | – | – | – | – | – | – | – | – | |
| M, 30–34 | – | – | – | – | – | – | – | – | |
| Adrielle Dos Santos et al. [77] | M, 44 (HCW) | B.1 | B.1.80 | – | – | – | Obesity and systemic arterial hypertension | – | Death |
HCW: Health Care Worker
#The words used to describe the symptoms in the table are from the original text