1/Concerning case of reinfection: healthy 45 year old was reinfected with the genetically distinct SARS-CoV-2 variant that harbors the E484K mutation - this is the variant that was recently reported to escape neutralizing antibodies 1/6

2/Second infection was more severe. Given the infections were 5 months apart its hard to know whether the immune response against the 1st infection simply waned, or, alternatively, if the variant virus managed to evade the immune response 2/6
https://www.preprints.org/manuscript/202101.0132/v1

3/Mutation is in RBD region of virus - the part that grabs human cell surface receptor, ACE2. Antibodies that bind RBD can block virus from entering our cells. But an earlier report this week showed that the E484K mutation in RBD is reducing the ability of antibodies to bind. 3/6

4/They found that the neutralizing activity of convalescent sera (rich in polyclonal antibodies) was reduced >10-fold against this variant. But they also found some sera samples that still neutralized it, perhaps because antibodies could still bind to other critical regions. 4/6

5/The fact that neutralizing function was diminished, not eliminated, suggested a strong vaccine response will still protect against the 484 variant. This reinfection case with that variant is discouraging, but it's still just one case and not enough to draw conclusions from. 5/6

6/However, our failure to control the pandemic gives the virus more opportunities to accrue more mutations and potentially evade vaccines. H/T @adamhamdy 6/6 https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1