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Medicine News Science

First Covid-19 Reinfection Has Been Documented (statnews.com) 168

Posted by msmash from the closer-look dept.
phalse phace writes: Researchers in Hong Kong on Monday reported what appears to be the first confirmed case of Covid-19 reinfection, a 33-year-old man who was first infected by SARS-CoV-2 in late March and then, four and a half months later, seemingly contracted the virus again while traveling in Europe. The case raises questions about the durability of immune protection from the coronavirus.

There have been scattered reports of cases of Covid-19 reinfection. Those reports, though, have been based on anecdotal evidence and largely attributed to flaws in testing. But in this case, researchers at the University of Hong Kong sequenced the virus from the patient's two infections and found that they did not match, indicating the second infection was not tied to the first. There was a difference of 24 nucleotides -- the 'letters' that make up the virus' RNA -- between the two infections. Experts cautioned that this patient's case could be an outlier among the tens of millions of cases around the world and that immune protection may generally last longer than just a few months.
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First Covid-19 Reinfection Has Been Documented More

First Covid-19 Reinfection Has Been Documented

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  • Who is surprised by this? (Score:3, Insightful)

    by OffTheLip ( 636691 ) on Monday August 24, 2020 @02:36PM (#60436901)
    Of more importance, will it happen again or is this a one off case? Maybe this person never fully recovered. Maybe not.

    • Re:Who is surprised by this? (Score:4, Interesting)

      by cayenne8 ( 626475 ) on Monday August 24, 2020 @02:45PM (#60436945) Homepage Journal

      Of more importance, will it happen again or is this a one off case? Maybe this person never fully recovered. Maybe not.

      Actually to me, the larger question is...what was the seriousness of the infection to the individual?

      I mean, if I"m one of the lucky ones that get it and have no or virtually no symptoms, or it doesn't make me sick and kill me...I don't give a damn how many times I get "infected".

      Was his first time worse than subsequent infection?

      We know a virus will mutate...and some things I've read seemed to indicate that subsequent virus mutations often mutate to where they are far less deadly and harmful to the hosts...THAT would be an interesting item too.

      I mean, if I can get infected and it doesn't harm me, like it appears close to maybe half the cases I've read about....infect me over and over, I don't care, I only care if I get infected AND it harms me in a lasting way.

      I'm NOT saying this is the same as the flu...but if you can show re-infection over time by a mutated variant then this is analogous to how people get the flu more than once and scientists have to try to predict and alter the vaccine year after year.

      This in and of itself isn't that scary....what's scary is how much damage it does.

      • Re:Who is surprised by this? (Score:4, Insightful)

        by Merk42 ( 1906718 ) on Monday August 24, 2020 @02:53PM (#60437001)

        I mean, if I"m one of the lucky ones that get it and have no or virtually no symptoms, or it doesn't make me sick and kill me...I don't give a damn how many times I get "infected".

        You'll still self quarantine during that time so you don't spread it to others who could get sick and/or die, right?

        • You'll still self quarantine during that time so you don't spread it to others who could get sick and/or die, right?

          Well, sure!!

          I mean, I'd treat it like I do when I have to evacuate for a hurricane...I just think of it as a short unplanned vacation.

          I work from home anyway...so, so far, this really hasn't impacted me that much, but if I didn't have this luxury, I'd treat it just like I mentioned above.

          A slight inconvenience that I'd make the best of...I have LOTS of things I can do while staying at home

        • How will he know he had it?
          Or you just mean they will spread it?

        • I mean, if I"m one of the lucky ones that get it and have no or virtually no symptoms, or it doesn't make me sick and kill me...I don't give a damn how many times I get "infected".

          You'll still self quarantine during that time so you don't spread it to others who could get sick and/or die, right?

          There is an interesting question about transmission in there that you may have both overlooked though. If the OP has it but is asymptomatic, how could he possibly be held liable for failing to self quarantine? We know that there have been asymptomatic carriers and spreaders.

          I'm all in favor of social distancing and everything else we can do to contain this - I'm wearing a mask right now while writing this at work even though none of my coworkers are in for the morning yet - but the people who get it

      • Comment removed (Score:5, Interesting)

        by account_deleted ( 4530225 ) on Monday August 24, 2020 @02:59PM (#60437019)
        Comment removed based on user account deletion

        • Re: (Score:2, Informative)

          by Anonymous Coward

          I assumed all along that, yes, people will generally produce antibodies which grant high immunity.

          Briefly. And then, to much clamor despite matching known virology, they fade.

          At which point (to no clamor, unfortunately) further exposure will be addressed not by already-present antibodies but by now-trained T cells. Meaning future infections will be grossly dampened - mild if not asymptomatic. These people are probably not an absolute-zero transmission risk, but their vectors (ie snot, saliva) would carry le

      • exactly-- the fact you are infected with any number of most benign covid type viri is of no real interest. About 20% of 'colds' are of that basic type. The only real question is will the next 'breed' make you really sick , or just be a normal bug.

      • Re:Who is surprised by this? (Score:5, Interesting)

        by flink ( 18449 ) on Monday August 24, 2020 @03:13PM (#60437095)

        Actually to me, the larger question is...what was the seriousness of the infection to the individual?

        I mean, if I"m one of the lucky ones that get it and have no or virtually no symptoms, or it doesn't make me sick and kill me...I don't give a damn how many times I get "infected".

        Having no symptoms doesn't mean there is no damage being done. There is mounting evidence that long term effects such as myocarditis are not uncommon even in asymptomatic carriers [forbes.com]. This is true even for relatively young people (median age of 49 in the study).

        If this bears out, you should definitely be concerned about even "mild" cases or repeat infections. It's also why we shouldn't be so blase about children getting it. Even if they don't have any serious visible symptoms, there could be all kinds of long term health effects that we don't know about yet. There could be a wave of people dropping dead from sudden heart failure in their 20s ten years from now because we rushed to send kids back to school and "COVID doesn't hurt kids".

        • Re: (Score:3, Insightful)

          by fatwilbur ( 1098563 )
          Maybe some better info [health.com] to round out your knowledge, speaking to the same study you refer to. Relevant quotes:

          "Essentially, the new research establishes a link between COVID-19 and myocarditis, or inflammation in the heart caused by viral infection, but a relatively weak one"

          "According to Dr. Cantillon, myocarditis sounds a lot more severe than it usually is. In fact, many viruses have been linked to myocarditis, and most people who develop the condition continue to be fully functioning, Dr. Cantillon

          • Re:Who is surprised by this? (Score:5, Informative)

            by Anubis IV ( 1279820 ) on Monday August 24, 2020 @05:54PM (#60437673)

            You're suggesting there isn't a cause for concern, but your own link says otherwise. I can only assume you thought no one would actually read your link, because two paragraphs down from where you stopped quoting we find this:

            The new studies underscore how important it is for medical professionals to keep an eye on the multi-system effects of COVID-19, and serve as a reminder that there's still much more to lean about this virus. “This is a sobering reminder that the pandemic is likely going to have a long tail in terms of public health implications," Dr. Cantillon says. It's also important to remember that, with all of the newly-emerging research, it's imperative to continent taking all COVID-19 safety precautions seriously, while also remembering to keep calm about the situation.

            Then there's the study cited in your quote [jamanetwork.com], which also says otherwise. From its conclusions:

            In this study [...] CMR revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), independent of preexisting conditions, severity and overall course of the acute illness, and time from the original diagnosis. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

            Which is to say, not only do they point out that 60% of recovered patients—regardless of their symptoms or severity—suffered from myocardial inflammation, they also point out that myocardial inflammation is merely the most common heart issue detected among the 78% of patients who had one (or more) heart issues. The study suggests that we don't yet know what the long-term effects of this disease will prove to be, which is exactly what the previous poster was saying.

            Your quote also suggests that 80% of patients are mild or asymptomatic, but that's pulled from a PDF the WHO published in March (i.e. at a time when the WHO was still recommending against wearing masks), and it most certainly doesn't address what the previous poster was saying, which is that the severity of your symptoms may not be a good indicator of the severity of long-term health complications you may suffer through later.

            You also mention that most people with myocarditis live normally with it as if that somehow makes it perfectly acceptable and not something to worry about in the least. While that may be true, that doesn't mean these people don't suffer. My mother had a closely related condition—pericarditis, an inflammation of the sac around the heart—that persisted for over a decade. It put an end to her days of running marathons with my dad, but she didn't have to stop doing the yard work that she loved, nor did we have to stop when we were out and about because she needed frequent rests. She seemed fine 99% of the time. But she used to love going on roller coasters with us because it reminded her of the skydiving she did in college. That had to stop. And she used to join us in the yard to run around and play games when I was a kid. That stopped.

            So while it's true that she was able to get by just fine, I wouldn't wish that pain or inconvenience on anyone, especially not if it's something that could last for years, as hers did, perhaps even a lifetime.

            It's good not to live in fear about the unknowns and what ifs, which is what I think you were getting at in general, but it's also good to recognize risks, including risks that aren't yet fully known, and make informed decisions about your tolerance for such risks, rather than being dismissive of there even being a concern.

          • I didn't see a mention in the article of whether there was a control in the 100 person sample study. What's the prevalence of myocarditis in individuals who are otherwise similar but haven't had Covid? Without that, how do we know that the novel coronavirus had anything to do with the results?

        • Re: (Score:3)

          by Kohath ( 38547 )

          If this bears out, you should definitely be concerned about ... repeat infections

          Shouldn't concern or lack of concern be based on evidence?

          Even if they don't have any serious visible symptoms, there could be all kinds of long term health effects that we don't know about yet. There could be a wave of people dropping dead from sudden heart failure in their 20s ten years from now because we rushed to send kids back to school and "COVID doesn't hurt kids".

          We know being under house arrest hurts kids. Why should we decide to do something we know is harmful based on supposition about something that might or might not happen? How long should we keep doing it, knowing that the harm only increases?

          Let's use evidence to help us decide.

      • Re: (Score:2, Informative)

        by Joce640k ( 829181 )

        I mean, if I"m one of the lucky ones that get it and have no or virtually no symptoms, or it doesn't make me sick and kill me...I don't give a damn how many times I get "infected".

        You might if you knew how much it can fuck up you internal organs, including your heart:

        https://www.google.com/search?... [google.com]

        • You might if you knew how much it can fuck up you internal organs, including your heart:

          Please correct me if I'm wrong, but from what I'd been reading that yes, while this happens, it is in a very small percentage of people that have had the disease.

          There are apparently a number of different, long last effects that can hit different people in different ways, but so far, it seems this are still outlier cases, and not the norm.

          • I don't care if I have a one in a million chance of dying, I'd rather have a almost negligible chance of dying.

          • You might if you knew how much it can fuck up you internal organs, including your heart:

            Please correct me if I'm wrong, but from what I'd been reading that yes, while this happens, it is in a very small percentage of people that have had the disease.

            78% of patients in this study had heart issues following their recovery [jamanetwork.com]. There's definitely some selection bias at play, given that 82% of their patients were symptomatic, which is far larger than we'd expect from a random sampling, but still, 78% is huge, even if it only applies to symptomatic patients. And that's just heart issues that they happened to be looking for.

      • Re: (Score:2)

        by sjames ( 1099 )

        RTFA!!! The second time was milder than the first, the second was with a different variant that is common in the U.S. (which isn't in general any milder or worse than the first variant he caught).

        Since this is a single case report, all we can really say is that apparently you can get it twice (no idea how likely that is) perhaps it was milder because he had it before, or perhaps he just had better luck with that the second time around.

      • often mutate to where they are far less deadly and harmful to the hosts
        The direction they _mutate_ to is more or less random.

        The question is do they get both:
        a) less deadly
        b) more infectinous

        Point b) is important, otherwise the "new mutation" does not out breed the old virus.

    • Re: Who is surprised by this? (Score:4, Informative)

      by bigpat ( 158134 ) on Monday August 24, 2020 @02:48PM (#60436973)

      Reading the story. They gene sequenced the virus the second time and found it was a different strain. So reinfection with a different strain is at least possible after 4 months in 1 case.

      Really the question is whether previous infection is as good as a vaccine, so people needed bother with a vaccine. Not whether it is 100% effective.

    • Re: (Score:2)

      by Nidi62 ( 1525137 )

      Maybe this person never fully recovered. Maybe not.

      But in this case, researchers at the University of Hong Kong sequenced the virus from the patient's two infections and found that they did not match, indicating the second infection was not tied to the first. There was a difference of 24 nucleotides -- the 'letters' that make up the virus' RNA -- between the two infections.

      Either he got infected with two different strains, or that one latent infection that he never recovered from really mutated.

      • Re:Who is surprised by this? (Score:5, Informative)

        by HiThere ( 15173 ) <charleshixsn.earthlink@net> on Monday August 24, 2020 @03:00PM (#60437027)

        24 nucleotides is a bit much for one virus strain in one person. This seems pretty clearly a second infection. What it doesn't say is how common this is. Also, as someone else indicated, how severe the second infection was compared with the first.

        That a corona virus should have a short period of immunity isn't a real surprise. Some do, some don't.

        • So far the second infection for this particular patient is asymptomatic. It was detected in a routine test (because he had just traveled to Spain), not because he fell ill a second time. So the level of immunity he developed from the first time around was not enough to prevent a new infection, but it may be keeping him from getting seriously ill.

          This may be what we can expect with a vaccine as well. Antibodies (and T-cells etc) in your blood won't stop an airborne virus that lands directly on the cells insi

    • Check back in 2-3 years, we might have a definitive answer given the wide variability in symptoms presented by the virus.

      The good news is he had no symptoms the second time around vs. mild the first time, so maybe there's some chance that you gain/retain partial immunity that makes subsequent infections mild and low risk.

      • Re: (Score:2)

        by HiThere ( 15173 )

        There's suggestive evidence that antibody based immunity is transient, but TCell based immunity is durable. This could fit with that. TCells take longer to get into action, and their action is killing off infected cells. This prevents rapid reproduction of the virus, but perhaps it doesn't stop it completely.

        OTOH, I'm a programmer, not a medic, so don't take this too seriously.

      • Comment removed based on user account deletion

    • Every person produces different antibodies. For some they might be merely sufficient under the right circumstances to kill it off. But not strong enough under non-optimal circumstances.
      However sometimes for some reason antibody responses fail to be memorized. For some deisease maybe more than others.
      Which regime were is thus is the question. I don't know how this rebalances the odds.

    • This person was infected by two different version of the virus. This person had two distinct infections.

    • "Of more importance, will it happen again or is this a one off case? Maybe this person never fully recovered. Maybe not."

      No, it was a different strain the second time, that's why they are so sure.
      Normal relapses have been widely documented, this isn't one.

    • Re: (Score:2)

      by eepok ( 545733 )

      Surprised? No. Hope defeated? Yes.

      A lot of people are going through a lot of shit. One tiny silver lining of the whole pandemic has been "if you can survive it, maybe you'll be immune". If we get many more re-infections, it may be that we won't be able to ever go "back to normal".

    • Re: (Score:2)

      by hey! ( 33014 )

      This is just one case report among 23 million confirmed cases worldwide.

      I think it's virtually certain we're going to find apparent reinfections given the volume of looking that's going on. We're highly susceptible to stumbling rare events -- either a confluence of improbable lab errors or legitimate but unusual biological events.

      I think we can be pretty certain that this kind of thing hasn't been commonplace *so far*. As for the future, who knows? We're rolling the dice 200,000+ times a day.

    • They said in the article and summary that the second infection doesn't match the first, meaning the virus mutated. It doesn't matter how long anti-body protection lasts if you're fighting a new virus. It means the virus can mutate in 4 months sufficiently that you can catch it again, meaning you'll need to get immunized every 4 months, and that's basically impossible.

    • Re: (Score:2)

      by GuB-42 ( 2483988 )

      Totally not surprised. There are millions of infected, they all have different bodies, some of them quite special. Rare blood types, organs in the wrong place, some even produce alcool in their guts, enough to get them over the legal limit for driving. Some are naturally immune from AIDS or malaria, while others are immunodeficient.

      On such scales, *not* finding a Covid-19 reinfection would have been surprising. And the fact that it is the first confirmed case in 6 months doesn't feel like bad news.

    • Re: (Score:2)

      by sjames ( 1099 )

      From other sources, this was certainly a new infection. The virus he had this time was not quite the same genetically as the one he had last time, so two different infections.

      Hard to tell much else about it since we only have a single case report.

    • Of more importance, will it happen again or is this a one off case? Maybe this person never fully recovered. Maybe not.

      The problem is that Covid is receiving more scrutiny than any disease in history. And as it displays differences between the way it behaves and our knowledge of previous diseases behave, the issue is that we can't know if this is truly a difference, or if other diseases have always behaved this way.

      There have always been known cases of where people get diseases over again. Outliers have always existed, but since no one has studied chicken pox infections like Covid is now under scrutiny, we just can't know

  • What is the re-infection rate for other viruses?

  • Relockdown (Score:2, Funny)

    by Anonymous Coward

    We need to shut everything down now. Everything needs to stop and everyone needs to stay inside on pain of criminal charges. We have to stay inside for however many years are necessary to stop all COVID-19 infections.

    We should get a drone force to monitor everyone and make sure they're all staying inside and dispatch authorities whenever someone leaves.

    We can no longer tolerate reckless capitalists with their restraunts and movie theaters and airliners. These things should have been banned long ago o

  • Two different strains (Score:5, Interesting)

    by DavenH ( 1065780 ) on Monday August 24, 2020 @03:07PM (#60437065)
    The outbreaks of Europe and Asia had different strains [cato.org] (clades) of the coronavirus.

    It's notable that reinfection is possible at all, but it would be a more dire finding if the reinfection were from the same strain, for which antigens had already been developed. The statistics look pretty good if this is truly the first reinfection documented out of hundreds of millions tested.

  • He didn't get sick though (Score:3)

    by Kohath ( 38547 ) on Monday August 24, 2020 @03:14PM (#60437101)

    If you get infected every three months and don't get sIck any time except the first time, then how do infections 2 through N matter at all?

    • Re:He didn't get sick though (Score:5, Informative)

      by Geoffrey.landis ( 926948 ) on Monday August 24, 2020 @03:24PM (#60437143) Homepage

      Yes, because (1) you are infectious even if you don't have symptoms, ,

      (2) Just because in this one instance the second case had no symptoms, that doesn't mean that every reinfection will be symptom-free.

      (3) even symptom-free infections may cause long-term damage.

  • Oh snap.

  • This man is clearly a crisis actor!

    REMEMBER MOAB

  • "Durability" (Score:3, Informative)

    by bill_mcgonigle ( 4333 ) * on Monday August 24, 2020 @04:56PM (#60437487) Homepage Journal

    > The case raises questions about the durability of immune protection from the coronavirus.

    No it doesn't. Given a large enough sample size, some people will have B-cells fail to hyperdifferentiate and create memory-B's.

    This is the kind of immunology that should be covered in high school. Physiology, Physiology, wherefore art thou Physiology?

  • One (Score:4, Insightful)

    by markdavis ( 642305 ) on Monday August 24, 2020 @05:23PM (#60437579)

    >"The case raises questions about the durability of immune protection from the coronavirus."

    Does it?
    One example? One?
    Sorry, but we ALL know (or should know) that there are a certain percent of people who can/will get sick with the same virus more than once. It happens with regular flu, with colds, even with things people are vaccinated against. Not everyone's immune systems are the same. This doesn't surprise or shock me at all. In fact, I would think if we DON'T find any cases of reinfection, the data is flawed.

  • Why is this surprising? Also, the flu vaccine is surprisingly ineffective as far as vaccines go. Get used to the new normal.

  • Or perhaps it's lung herpes... (Score:3)

    by Darkling-MHCN ( 222524 ) on Monday August 24, 2020 @09:31PM (#60438073)

    Perhaps this virus never goes away, and just lays dormant like the herpes virus, resurfacing whenever the immune system gets run down.

    There's a lot they don't know about this virus.

  • 2nd infection was milder because of T Cells (Score:3)

    by George_Ou ( 849225 ) on Tuesday August 25, 2020 @01:43AM (#60438347)
    Unsurprisingly, the second infection was milder. Having insufficient antibodies means you can get infected, but your T Cells will mount a vigorous defense and you don't get sick the second time. Another big plus is that your antibody levels ramp up much sooner and much stronger than the first which means it acts like a booster shot. Here's a nice illustration of antibodies when reinfected. https://www.clinisciences.com/... [clinisciences.com]

  • It is well-known that it heavily mutated since its beginnings.

    It's more like the next cold season. Of course immunity from the last one won't help much.

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