Reinfection
First case of reinfection
Dr. Kelvin Kia Wang
First case of reinfection, 23 million COVID-19 cases
Journal Clinical Infectious Diseases
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
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
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