Apr 13, 2020

Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster

Posted by in category: biotech/medical

Can you be reinfected with Covid-19?

I’m skeptical as to whether reinfection is possible or not from Covid-19. However studies have shown that the virus lasts longer than 2 weeks within the human body:

10 days: https://doi.org/10.1101/2020.03.05.

More than 2 weeks: https://jamanetwork.com/journals/jama/fullarticle/2762452

37 days: https://www.thelancet.com/…/PIIS0140-6736(20)30566…/fulltext

We need to consider the possibility of faulty testing. As we learn more about Covid-19 we will develop better methods for testing. The other more likely scenario is something South Korean infectious disease experts stated, that the virus lies dormant within the human body and becomes active again.

Reinfection may be possible if people are especially frail, old, and have compromised immune systems. However it is too early to know for sure.

Background: In coronavirus disease 2019 (COVID-19), current case definitions presume mainly lower respiratory tract infection. However, cases seen outside the epicenter of the epidemic may differ in their overall clinical appearance due to more sensitive case finding. Methods: We studied viral load courses by RT-PCR in oro- and nasopharyngeal swabs, sputum, stool, blood, and urine in nine hospitalized cases. Infectious virus was detected by cell culture. Active replication was demonstrated by analysis of viral subgenomic replicative intermediates. Serology including neutralization testing was done to characterize immune response. Results: Seven cases had upper respiratory tract disease. Lower respiratory tract symptoms seen in two cases were limited. Clinical sensitivity of RT-PCR on swabs taken on days 1–5 of symptoms was 100%, with no differences comparing swab and sputum samples taken simultaneously. Average viral load was 6.76x10E5 copies per swab during the first 5 days. Live virus isolates were obtained from swabs during the first week of illness. Proof of active viral replication in upper respiratory tract tissues was obtained by detection of subgenomic viral RNA. Shedding of viral RNA from sputum outlasted the end of symptoms. Seroconversion occurred after about one week. Conclusions: The present study shows that COVID-19 can often present as a common cold-like illness. SARS-CoV-2 can actively replicate in the upper respiratory tract, and is shed for a prolonged time after symptoms end, including in stool. These findings suggest adjustments of current case definitions and re-evaluation of the prospects of outbreak containment.

The authors have declared no competing interest.

Funding Statement

This work was funded by grants from the German Ministry of Research (01KI1723A) and the European Union (602525) to C. D. as well as by the German Bundeswehr Medical ServiceBiodefense Research Program. The funders had no role in study design, data collection and analysis or decision to publish.

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