Health A man suffered a second coronavirus infection worse than...

A man suffered a second coronavirus infection worse than the first, raising questions about immunity

Saturday, October 17, 2020 11:22



This 25-year-old man, a resident of Washoe County, Nevada, United States, was the fifth person in the world who had the bad experience of contracting coronavirus twice. Due to this background, your case would not be news; However, it deserved a dedicated study by The Lancet Infectious Diseases because, with also double misfortune, the second infection was much more serious than the first, with more severe COVID-19 symptoms. The episode raised important questions about the duration of immunity that the human body can generate against SARS-CoV-2. When much of the hopes of ending the pandemic center on the vaccine, seeing a failure of immunity is daunting.

The first time the Nevada boy was tested on April 18, he had a sore throat and headache, cough, nausea and diarrhea. It had been like this for a few weeks; the test came back positive. He recovered, in isolation, on his own, and on April 27 he finally felt no symptoms at all. After that, in two controls carried out on May 9 and 26, he tested negative for SARS-CoV-2, which declared him free of infection. As she had no other concomitant diseases, no special care was indicated.

However, two days later everything changed.

Although after the first infection he tested negative in two control tests, in a matter of days the young man from Nevada returned to presenting symptoms, and more severe.  (OMAR MARTÍNEZ / CUARTOSCURO.COM)
Although after the first infection he tested negative in two control tests, in a matter of days the young man from Nevada returned to presenting symptoms, and more severe. (OMAR MARTÍNEZ / CUARTOSCURO.COM)

On May 28, the young man felt the same symptoms again, now complicated by fever and dizziness. His condition was getting worse, until on June 5 he had to consult his doctor. The coronavirus study tested positive; his blood oxygen level was below what would have allowed him to return home, so he was referred to a hospital for admission. He was there until he regained his breathing capacity.

To establish whether it had been a recurrence of the first infection, doctors compared the genome of the virus detected in the young man in April with that detected in June: They found, surprisingly, that it was too different, said the study’s lead author, Mark Pandori, of the University of Nevada. It was a new contagion, caused by a second transmission from another person.

None of the other known cases – it is more than likely that there are more second infections that have not been reported – in Hong Kong, Belgium, Ecuador and the Netherlands had a worse manifestation in the new infection.

Five known cases of second infections in the world, in Hong Kong, Belgium, Ecuador, the Netherlands and the US, suggest that masks and social distance will continue to be necessary even for those who have recovered.  (REUTERS / Mike Blake)
Five known cases of second infections in the world, in Hong Kong, Belgium, Ecuador, the Netherlands and the US, suggest that masks and social distance will continue to be necessary even for those who have recovered. (REUTERS / Mike Blake)

An MIT Technology Review article highlighted the implication of such a finding: “The fact that you have been infected once does not mean that you have protection against being re-infected, even if the cases remain very rare, with only five identified among those almost 40 million confirmed worldwide ”.

In practice, this means that those who have survived COVID-19 cannot feel the relief of being immune, at least not completely: “They still have to stay vigilant and follow the advice on social distancing, wearing masks and avoiding crowded and poorly ventilated spaces “, warned the publication of the Massachusetts Institute of Technology (MIT). For infectious disease experts, he added, it was not entirely unexpected bad news: “Other coronaviruses, such as the common cold, are seasonal.”

However, “there are still many questions that researchers are struggling to answer soon.” Among them: “How much protection does having COVID-19 confer? Does protection come mainly from antibodies or from T leukocytes? How long does it last? And perhaps the most pressing question: “What does this mean for the medical treatments that are currently being developed, and for vaccines?”

The most urgent question posed by this study is what the disappearance of immunity means for the medical treatments that are currently being developed and especially for vaccines.  (REUTERS / Dado Ruvic)
The most pressing question posed by this study is what the disappearance of immunity means for the medical treatments currently being developed and especially for vaccines. (REUTERS / Dado Ruvic)

The Lancet recalled that, as with other agents, the human body generates a detectable immune response against SARS-CoV-2, but “the susceptibility of previously infected people to reinfection is still not well understood”, nor has it been elucidated ” the degree to which this immune response indicates protective immunity to subsequent infection with SARS-CoV-2 ”. In studies on other coronaviruses, the scientific publication recalled, immunity lasts between one and three years.

The case of the young man from Nevada, the first double contagion recorded in the United States, is another reminder of how little is still known about this novel disease. “The mechanisms that could explain why the second infection was more serious are only a matter of speculation,” the study continued. “In the first place, a very high dose of the virus could have caused the second instance of infection, and induced a more serious illness. Second, it is possible that the reinfection was caused by a more virulent version of the virus, or more virulent in the context of the patient ”.

It is also possible that, given the recent immune response to the first infection, the patient’s body has overreacted. “This has been documented in diseases such as dengue: antibodies made in response to one strain of the virus cause problems when infected with another strain,” interpreted the BBC. In other words, far from causing immunity, the first infection makes the second worse, due to the sensitivity of the body’s defense system.


“The susceptibility of previously infected people to re-infection is still not well understood,” the new study warned. (REUTERS / John Sibley)

“Our findings have implications for the role of vaccination in the response to COVID-19,” Pandori and colleagues concluded. “If we really study a case of re-infection, the initial exposure to SARS-CoV-2 might not provide a 100% protective level of immunity for all individuals.” That is something that, in the case of the flu vaccine, for example, is well known: every year it must be adjusted according to the prevailing strains. According to scientists, that could be the case for the coronavirus as well.

Analyzing the study, Paul Hunter, from the University of East Anglia, told the BBC that the case was “very worrying”, given the short time that passed between one infection and another – which would indicate a very short immunity – and the severity of the infection. second. However, since the pandemic has affected millions, that the instances of re-infection are so few is a sign that these are rare events. “It is too early to say with certainty what this finding means for an immunization program. But it reinforces the idea that we still do not know enough about the immune response to this infection “, he closed. /Infobae



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