A research work of the Espiritu Santo University has revealed a first case of persistence and reactivation of SARS-CoV-2 in an infected patient in Guayaquil.
This represents a warning about the possibility of viral persistence and reactivation in people exposed to SARS-CoV-2, which should be considered as a potential risk when evaluating policies related to the epidemiological control of the virus and transmission routes.
In Guayaquil, a suspected case of persistence of SARS-CoV-2 with reactivation was reported in a 35-year-old patient, who presented positive RT-PCR on April 7 with mild symptoms of the disease. On August 7, 2020, the presence of the virus was again diagnosed through an RT-PCR test, this time with severe symptoms.
Immunity against SARS-CoV-2 in the population is a major concern for the management of the COVID-19 pandemic. A recent study showed that the presence of antibodies against seasonal human coronaviruses is short-lived, 11 months. In addition, several studies in Europe have shown that the presence of anti-SARS-CoV-2 antibodies ranged from 0 to 42.2% overall.
The results show the possible persistence of SARS-CoV-2 in the testes, urinary tract and feces. Suggesting the possibility of sexual transmission and transmission via the fecal-oral route. SARS-CoV-2 could be shed and eliminated through the gastrointestinal tract. However, studies are lacking to verify whether it can remain viable and infectious in stool, urine and semen samples. The possibility that SARS-CoV-2 could persist in the testes and be sexually transmitted becomes a major concern.
In this study, samples were obtained one week after the patient was discharged from the hospital while severely affected by his second episode of COVID-19. To date, the presence of SARS-CoV-2 in seminal fluid has been investigated in men with positive nasopharyngeal swabs and still presenting symptoms even 2 to 3 days before semen collection.
The testis could be a potential viral reservoir for SARS-CoV-2 due to high levels of ACE2 expression in spermatogonia, Leydig and Sertoli cells. Therefore further studies are essential to determine the presence of SARS-CoV-2 in semen, including patients with severe COVID-19, reinfection and viral persistence.
