First reported COVID reinfection

First reported COVID reinfection

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Reinfection
First case of reinfection

Dr. Kelvin Kia Wang

https://hub.hku.hk/cris/rp/rp01384

First case of reinfection, 23 million COVID-19 cases

Journal Clinical Infectious Diseases

https://edition.cnn.com/2020/08/24/health/covid-19-reinfection-hong-kong-study/index.html

https://twitter.com/cwylilian/status/1297857565385093121/photo/1

Not prolonged viral shedding

33-year-old man, good health

Immunocompetent

First infection

3 days, cough, sore throat, fever, headache

Hospitalized

Serum at day 10, negative for IgG

26th March

Oropharyngeal antigen PCR diagnosis

14th April

Discharged asymptomatic

142 days

2nd infection

Spain - UK – HK

15th August

Oropharyngeal positive at HK airport

Hospitalised, remained asymptomatic

T, 36.5

HR, 86

BP, 133/94

SaO2, 98 RA

CRP, 8.6 mg / L

Slightly raised, suggesting acute infection

Declining during hospitalisation

Hypokalaemia

Viral load progressively decreased

Serum day 5 of hospitalisation, positive

Genome analysis

Full sequencing performed after first and second episode

Different clade/lineage

Truncation of 58 amino acids in the virus genome

23 nucleotide changes

13 of which non-synonymous mutations

4 in the spike protein

First strain

Mostly close to strains from USA or England collected in March and April

Second strain

Switzerland and England collected in July and August

Evidence

Genomics, phylogenetic analysis

142 days, viral shedding (104 days in one pregnant woman)

Raised CPR indicating acute infection

Patient had recently returned from Europe with July and August strains

Implications

Unlikely herd immunity can eliminate SARS-CoV-2

Subsequent infections likely to be milder

Virus likely to go on circulating in the human population

Vaccine will not provide lifelong infection

Vaccine studies should include patients who have recovered from COVID

People who have had COVID should be vaccinated

People who have had COVID should continue with public health measures

Residual low level of antibodies may have controlled the second infection

WHO

https://www.who.int/docs/default-source/coronaviruse/media-advisory-covid-19-virtual-press-conference-24-august-2020.pdf?sfvrsn=e22ef35e_0

Dr Maria Van Kerkhove

I haven't read the study

Our expectations, people who are infected with this virus develop an immune response

People do develop an immune response, not completely clear yet is how strong and how long lasting

Severe, mild, asymptomatic cases, develop an immune response

More than 24 million cases

On a population level

Longitudinal studies, following the same individual underway

Inductive thinking, Bottom up
Deductive thinking, Top down