A doctor in Brazil developed COVID-19 twice in three months, with the second attack more severe than the first, in the most recent example of coronavirus reinfection.
In a letter to the editor of the Journal of Medical Virology, the case of the nameless 36-year-old woman who tested positive for coronavirus for the first time at the end of March was described in detail. Her symptoms included a runny nose, sore throat, diarrhea, lack of energy and headaches.
After 11 days of symptoms, she began to develop a rash on her right leg and suffered from “severe” pain in her lower limbs. This area was also sensitive to touch. About 24 days after she became ill for the first time, her symptoms cleared up.
After her recovery, the doctor resumed work in the COVID-19 intensive care units in two hospitals. Antibody tests were negative 33 and 67 days after she developed the first symptoms.
Approximately 12 weeks after the woman was first given COVID-19, she was again affected by the disease, with a stuffy and runny nose and headaches. She also lost her ability to smell and taste and felt tired.
After 10 days she became more and more exhausted and still could not smell and taste. On day 11 she visited an emergency room where a scan showed that she had developed viral pneumonia due to the corona virus. The authors of the letter said that the second time the woman was infected, her body showed a more intense inflammatory response to the virus.
After her second COVID-19 infection, it took about 24 days for her lungs to return to normal in the scans.
The authors of the letter said there was “a high probability” that the two episodes of infection were caused by different strains of the coronavirus, and each form could have caused different symptoms.
“There is still no guarantee of extended immunity,” the team wrote.
The first known example of a person re-infected with the corona virus was reported in Hong Kong in August, and since then a handful of other similar cases have been reported.
There is evidence that some people who had a mild case of COVID-19 may not have a strong and sustained immune response and their antibody levels drop after two to three months, the authors of the paper wrote.
The case study was published the day the South Dakota Department of Health said it was investigating 28 cases of “possible” coronavirus re-infection in the state.
The state epidemiologist, Dr. Joshua Clayton, said at a press conference on Wednesday that the ministry is waiting for the U.S. Centers for Disease Control and Prevention (CDC) to provide guidance on the classification of reinfections. Clayton said his public health laboratory had partnered with the University of Minnesota to conduct genetic testing to see if patients had contracted various forms of coronavirus.
In the section of its Web site dedicated to reinfection, updated Tuesday, the CDC said: “Confirmed and suspected cases of reinfection of the virus that causes COVID-19 have been reported, but they remain rare. It said it had provided information to state and local health authorities to help investigate suspected cases and said it would update as it learned more about the phenomenon.
Daniel Davis, Professor of Immunology at the University of Manchester in the UK, who was not involved in the case study, told Tekk.tv that it was unclear how frequent reinfections occur.
Commenting on the Brazilian doctor’s case, Davis said it had been shown earlier that patients can have worse symptoms after reinfection, but in general it was not yet known how they differ between a first and a second infection.
“This case shows that we urgently need more research into what happens to people who are infected with this virus over long periods of time, even if they are exposed to the virus a second time,” he said.
Ian Jones, Professor of Virology at the University of Reading in the UK, told Tekk.tv that the doctor in Brazil “had been constantly exposed to the virus, so the possibility of reinfection was high and the second attack may have been due to the fact that she had not produced long-lasting antibodies after the first infection”.