Another preliminary report on COVID-19 re-infection.

Another case of a recurrent infection with COVID-19 has been reported. This case was similar to the Hong Kong case in that the secondary infection was identified because the viruses from these patients were both amplified by PCR and sequenced and found to be different from the virus initially isolated when the patient first had symptoms. Basically, this suggests each patient was infected with two different types of corona virus.

The patient was in Reno Nevada and was different from the Hong Kong case in that the patient was clinically ill with the second infection. This suggested that there was no immune protection as might have been thought with the second infection from the Hong Kong patient.

This case again received tremendous media attention, but it turns out it was not even an accepted manuscript. It was posted on a pre review site at The Lancet family of journals. The journals have a disclaimer about these non-peer reviewed postings. It cautions the reader as follows:

These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet or submitted directly via SSRN (Elsevier Publisher’s pre-print website.). The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed.”

Despite this caution, none of the news sites I read identify this as “preliminary research!”  

There is essentially very little clinical information in this report. While the authors state that the patient developed antibody after his second bout of infection, there is no determination if antibody was present after his first infection. While the two viral isolates are convincingly different, it is not clear that the individual was infected with SAR-CoV-2 the first time he became ill.

Is there another reason why we are we now seeing reports of finding different corona viruses in a single individual by PCR? This was brought to light by an article in the New York Times. The viral swab (PCR) test currently used increases the virus genetic material taken from the patient 240 (over 1 billion) times. This is a massive amplification allows the assay to detect minute amounts of virus, and even dead virus. This could allow people who are contaminated with small amounts of dead SARS-CoV-2, but not infected with the virus, to be identified as PCR positive. Therefore, the first virus determinations in these patients may not have been true infections that provided immunity.

While there may be some rare cases of recurrent COVID-19, they are certainly not the norm and may simply be a laboratory report, not a true infection… 

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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