As COVID-19 cases continue to rise worldwide, experts are faced with a critical question: can a person catch the disease a second time? The answer to this question influences, among other things, the prospects of the vaccine and its ability to protect us from the disease.
In late August and earlier this month, news reports of COVID-19 reinfections surfaced from different parts of India – Bengaluru, Mumbai and Hyderabad.
On September 15, 2020, researchers from the Government Institute of Medical Sciences, Greater Noida, and the Institute of Genomics and Integrative Biology (IGIB), New Delhi, uploaded a preprint paper confirming two cases of reinfection from India. The patients – a 25-year-old male and a 28-year-old female, both healthcare workers in the Noida hospital – got infected with a different variant of the virus the second time, about three and a half months after their first infection. The next day, the IGIB team also confirmed reinfection in four Mumbai healthcare workers, although the report is yet to appear online.
The healthcare workers from Noida had more viral particles than when they got infected the first time, although they remained asymptomatic. The researchers also noted that the viral strain they were reinfected with contained a mutation that wasn’t present earlier, and which allowed the virus to resist neutralising antibodies – the kind of antibodies that prevent the virus’s entry into the body.
This is probably the first report of asymptomatic infection and reinfection, and it calls for better surveillance.
“As a significantly large number of people who are infected are asymptomatic, without surveillance, we would never be able to estimate the real numbers of infection. Therefore, surveillance of healthcare workers, who are at higher risk than the population, would be something really worth considering,” Vinod Scaria, a senior scientist of genome informatics at IGIB and one of the authors of the study, told The Wire Science.
Upasana Ray, a senior scientist of infectious diseases and immunology at the Indian Institute of Chemical Biology, Kolkata, agreed that long-term patient monitoring is important irrespective of the symptoms. She added that more gene-sequencing data should help us identify and understand the type of virus in circulation, and understand when a new ‘variant’ shows up.
Sequencing the virus’s genome also helps distinguish between reinfection, where the virus enters the body a second time and infects the person, and reactivation, where the virus remains in an inactive state in the body and later becomes active again.
Epidemiologists had speculated on the possibility of reactivation and reinfection of the virus even in April, when about 51 patients in South Korea who had been ‘cured’ of the disease tested positive again. South Korea’s Centers for Disease Control and Prevention initially proposed that they were cases of reactivation of the virus. But upon further research, they announced that the test results were all false positives: the test kit had detected remnants of the virus that were not infectious.
Other researchers reported the first formal case of reinfection on August 24, 2020, when a 33-year-old man from Hong Kong tested positive for the SARS-CoV-2 virus about four and a half months after the first infection. The reinfection, however, was less severe and the patient was asymptomatic.
One way to confirm reinfection is to test whether viral strains from the two infections are different. This is useful because as the virus mutates, different strains of the virus circulate in different regions at different times. In the Hong Kong case, scientists confirmed that the viral strain involved in the reinfection was different from the first infection. In fact, the reinfection strain was most closely related to a strain circulating in Europe around July-August, where the patient had travelled at the time. The study was published on August 25 in the journal Clinical Infectious Diseases.
Another case of reinfection has been reported from Nevada, in the US, where – unlike the Hong Kong case – the symptoms were worse when a 25-year-old man contracted the virus a second time. The authors of the preprint paper confirmed this to be a case of reinfection as five nucleotides present at specific places of the viral RNA from the first infection were different in the viral RNA from the second infection.
That said, the authors also considered another possibility: that the virus from the first infection evolved into a different type inside the body. If that were true, this would be the fastest rate of the virus evolving inside a person – nearly four times as fast as is known now.
Mind the rarity
Scientists have also confirmed instances of reinfection in Europe and South America. As of today, ten cases of reinfection have been confirmed from around the world.
These cases raise many questions. For example, are reinfections frequent or rare? Do subsequent infections evoke milder symptoms or worse? Can those who have been infected the second time spread the virus while remaining asymptomatic? And how do reinfections change the prospects of a vaccine?
A syringe with a vaccine is seen ahead of trials by volunteers testing for COVID-19, and taking part in clinical trials for potential vaccines at a research centre in Johannesburg,
In a press conference held on September 15, Balaram Bhargava, director-general of the Indian Council of Medical Research, said that although COVID-19 reinfections are possible, they are “very, very rare”, and added that it’s not a matter of serious concern.
Source: https://science.thewire.in/the-sciences/covid-19-reinfection-reactivation-reports-gene-sequencing-studies-explainer/
Please take a look at this link.
https://academic.oup.com/pcm/advance-article/doi/10.1093/pcmedi/pbaa031/5901533
Reinfection of COVID-19 is really very rare but it happens, it is now evident worldwide. I think the following questions need to be highlighted in the ongoing COVID-19 researches- (i) whether the same serotype reinfects or different? (ii) what is the average interval between 1st infection and the 2nd? (iii) why some people are getting reinfected while others not? (iv) why is it mild to some people, asymptomatic, and fatal to others? (v) which group, symptomatic or asymptomatic, is more susceptible to reinfection? For the vaccines, together with other steps, I think we should consider and test the effectiveness of it against all active serotypes on all kinds of people, symptomatic and asymptomatic.
Yes , it is possible. Many discharged patients from the hospital where i'm working turn positive again after first infection. And there was one case who was positive twice then negative then positive again.
Still there is a very, very small number of people that got virus twice, it's proved for just a few, and they were asymptomatic.
Yes, reinfection happening everyday but the rate still not so high...
This reinfection giving us a message that we should more careful and aware about the CORONA VIRUS...
Reinfection is a matter of the body’s immune response and the evolution of the virus itself. If these patients’ initial immune responses to their first infection weren’t robust enough, they could be susceptible to getting infected again. People who’ve been infected with SARS-CoV-2 or who are in the vaccine trials, that people tend to make a good amount of antibodies against the spike protein, which the virus uses to infect a cell and is a major target for vaccines. These individuals could have failed to make sufficient levels of antibodies or in the asymptomatic case, their antibodies may have protected them from more severe disease. On the other hand, antibodies are not the end-all, antibodies do decrease over time but that doesn’t mean we aren’t protected. An infection usually also triggers memory cells that lie in wait to respond when exposed to the same virus in the future. Some people who’ve recovered from SARS-CoV, which caused a global outbreak in 2003, were able to produce antibodies that recognized SARS-CoV-2. These examples of cross-protection, like examples of reinfection, may just be outliers.
https://labblog.uofmhealth.org/rounds/should-we-worry-about-covid-19-reinfection
Immunologists had expected that if the immune response generated after an initial infection could not prevent a second case, then it should at least stave off more severe illness. That’s what occurred with the first known reinfection case, in a 33-year-old Hong Kong man. They always presumed people would become vulnerable to Covid-19 again sometime after recovering from an initial case, based on how our immune systems respond to other respiratory viruses, including other coronaviruses. It’s possible that these early cases of reinfection are outliers and have features that won’t apply to the tens of millions of other people who have already shaken off Covid-19.
https://www.statnews.com/2020/08/28/covid-19-reinfection-implications/
Please see the following RG link:
Article Will we see protection or reinfection in COVID-19?
Please take a look at this link.
https://academic.oup.com/pcm/advance-article/doi/10.1093/pcmedi/pbaa031/5901533
Please also go through the following RG links.
Article Recurrence of COVID-19 after recovery: a case report from Italy
Article SARS-CoV-2 recurrent RNA positivity after recovering from co...
Preprint Human coronavirus reinfection dynamics: lessons for SARS-CoV-2
Arvind Singh very valuable resources, interesting ongoing research... Still there is not many cases of reinfections and it is encouraging...
Recovered patients are reinfected because the acquired protective immunity from the SARS-CoV-2 is short lived.
https://www.nature.com/articles/s41591-020-1083-1
Preprint Longitudinal evaluation and decline of antibody responses in...
Exposure to SARS-CoV-2 virus does not guarantee immunity, reinfection causes more severe symptoms.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30764-7/fulltext
That is just a few cases out of 37.000.000 infected, so it is more an exeption if you ask me.
https://www.ajmc.com/view/first-case-of-covid-19-reinfection-detected-in-the-us
Dear Rajko Sekulovic in addition to the references provided by Arvind Singh here is another very recent useful link entitled What reinfections mean for COVID-19
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30783-0/fulltext
Dear Arvind Singh Frank T. Edelmann Anwar A. Abdulla Manal Hadi Kanaan thanks a lot on very valuable references!
SARS-CoV-2 re-infection: a case report from Bangladesh
https://www.banglajol.info/index.php/BJID/article/view/50164
Dear Mr. Hamed and Mr. Bin Emran,
Thank you on these up-to-date case reports!
A new study which is yet to be peer reviewed reveals that immunity against SARS-CoV-2 could last for at least six months.
https://www.biorxiv.org/content/10.1101/2020.11.15.383323v1
https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html
there is not enough evidence about the effectiveness of antibody-mediated immunity to guarantee the accuracy of an “immunity passport” or “risk-free certificate.” People who assume that they are immune to a second infection because they have received a positive test result may ignore public health advice.
Yes! There is a risk of potential reinfection as reported in some countries worldwide.
Coronavirus immunity lasts at least 8 months after infection, and perhaps even years, new research shows!
https://www.businessinsider.com/long-term-coronavirus-immunity-months-years-2020-11
Yes, there are cases of reinfection. This is due to the fact that the SARS-CoV-2 (Covid-19) coronavirus mutates and creates new variants of this virus.
Regards,
Dariusz Prokopowicz
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