Researchers from the University of Nevada-Reno School of Medicine and the Nevada State Public Health Laboratory detailed the two coronavirus infections of the unnamed individual, a Reno, Nevada native, in a case report which has not yet been peer-reviewed and is currently only available as a pre-print, according to Newsweek.
In the case report, we learn the 25-year-old man developed some of the classic signs of COVID-19 in late March: sore throat, cough, diarrhea, headache and nausea. After testing positive on April 18, he began to gradually feel better, and the virus appeared to leave his system, seemingly verified with two consecutive negative tests in May.
A few weeks after his last negative test for the coronavirus, the man started feeling ill again, testing positive for COVID-19 once again on May 31. At this time, his symptoms included fever, headache, feeling dizzy, as well as a cough, nausea and diarrhea.
UNR Med scientists, led by our Nevada State Public Health Laboratory, are studying a likely case of COVID-19 reinfection. Forty-eight days after testing positive—and after two consecutive negative tests—a Washoe County patient tested positive once again. pic.twitter.com/CsiJrFDUIQ
— UNR Med (@unrmed) August 27, 2020
Five days later, the patient was hospitalized after his condition worsened, and tested positive for the coronavirus again. Samples from the patient also showed he had antibodies against the coronavirus.
The researchers also point out that the patient had no immune problems that might explain reinfection, and he was not taking immunosuppressant drugs. The researchers thought at first that the virus may have been hiding in his body after the first infection – mutating, changing and eventually developing into something that caused him to get sick with COVID-19 a second time.
They ultimately rejected that theory after doing genetic testing on the patient’s blood samples from the first and second infection. the two viruses were so different that it would have been nearly impossible for the virus to change that quickly inside his body. The only explanation was that he had been infected by a slightly different version of the coronavirus.
“Having had it doesn’t mean you can’t get it again, that’s what this shows,” Dr. Mark Pandori, director of the Nevada State Public Health Laboratory and co-author of the study, said in an interview with ABC’s “World News Tonight.
A Nevada lab has reported the first confirmed coronavirus reinfection in the U.S., and the first in the world known to have brought on severe symptoms pic.twitter.com/yQV0XWoJX7
— The New York Times (@nytimes) August 28, 2020
“It tells us possibly things we still don’t know about this virus … or that there is a danger that even if you’ve had it that your immune system may not protect you from a significant illness next time.”
Comparing cases not a good idea
One apparent difference between the Reno case and the first confirmed reinfection – the Hong Kong case – is that the individual in Hong Kong had an easier time with his reinfection, suggesting the first infection had provided some immu nity.
However, the man from Reno had a harder time when he was reinfected with the virus, ending up hospitalized and requiring oxygen.
A 25 yr old patient in Nevada has a confirmed case of #COVID19 reinfection (48 days apart between 1st and 2nd PCR).
This time, unlike the case in Hong Kong, the immune system did not protect this person from reinfection or disease. (1/n)August 28, 2020
Dr. Akiko Iwasaki, Waldemar Von Zedtwitz professor in the Department of Immunobiology at Yale University, wrote on Twitter that this patient’s case was different from the Hong Kong patient because his prior infection didn’t seem to help him fight off the virus. “This time, unlike the case in Hong Kong, the immune system did not protect this person from reinfection or disease,” her tweet read.
Many scientists are saying we must not compare different cases because there is so much we still don’t know for sure, and no two cases are alike. Pandori said: “After one recovers from COVID-19, we still do not know how much immunity is built up, how long it may last, or how well antibodies play a role in protection against a reinfection. This is a novel disease. We still have a steep learning curve ahead and lots of work to do, especially as inconvenient truths arise.”
“If reinfection is possible on such a short timeline, there may be implications for the efficacy of vaccines developed to fight the disease. It may also have implications for herd immunity,” Pandori said.