One year after the first case of COVID-19 reinfection in the world, how often are these pictures in Argentina?

Aug 24, 2020 the world’s first case of COVID-19 reinfection has been confirmed. It was a 33-year-old Hong Kong citizen who was infected with another strain in Spain. From now on the question began to ring on the world stage as to whether we would ever get collective immunity, understood by WHO as indirect protection against an infectious disease obtained when a population becomes immune, either following vaccination or after presenting the infection previously.

According to the Argentinian Ministry of Health, the definition of a case of re-infection with COVID-19 includes anyone with RT-CRP detectable for SARS-CoV-2 after 45 days or more after first infection with SARS-CoV-2, during which the case remained symptom-free and / or an undetectable RT-PCR for SARS-CoV-2 was obtained and infection with another causative agent was ruled out.

Now, a year after the first documented case, Are there cases of people who got infected with the new coronavirus last year and fall ill again? Do you see these blocks in the guards of hospitals and medical clinics? If so, Why is this happening as the vaccination campaign in Argentina begins to gain momentum? Could these cases be linked to a drop in immunity over the months? Does the presence of variants influence? So many questions that make it essential to know what happens in these scenarios. For that, Infobae consulted with recognized infectious disease specialists for more details.

According to the infectologist Elena Obieta, Head of the Communicable and Emerging Diseases Department of the Municipality of San Isidro and member of the Argentinian Society of Infectious Diseases (SADI), “fortunately, reinfection is an extremely rare phenomenon. When we see a person who had COVID-19 six months or even more ago, they come back with symptoms, we dab them and most of the time the result is negative”.

“This has to do with the persistence of immunity, beyond humor (that of antibodies), The cell phone also has to do with these processes and in any case the person if it was, I insist on the fact that it is very rare, a case of reinfection, to know for sure it is necessary to be sure that it had a negative CRP on discharge, which we no longer do because it is a very expensive procedure (the double test); it would have to have the negative certification and that after four or five months the result is again positive “, he warned and added:”if the patient has a history of travel or has a high viral load, genotyping is indicated or recommended to see if it is a different strain from the original infection”.

Reinfection is an extremely rare phenomenon

Obieta clarified: “The low rate of reinfection we are seeing in Argentina and around the world has more to do with the duration of immunity, that is to say defenses, subjects, not only by antibodies, but somewhat due to the impact of vaccination since many patients who had COVID-19 in the first wave are vaccinated, so natural COVID plus 1 or 2 doses of vaccine ideally gives a high level of protection, so these people do not reinfect themselves”.

“Even having had COVID-19 and not being vaccinated, the possibility of reinfection in a patient who has already had the coronavirus is very low, since it is about cellular immunity, that is to say, these memory lymphocytes which are activated and in the event that the virus wants to enter the body, they do not leave it because they start to manufacture antibodies ”.

What about worry variants? “Their appearance is always worrying because they are either much more contagious – as is the case with Delta – or because they can have this famous and dreaded immune breakout, which means that the virus” manages “to modify its key to avoiding antibody locks, so cells can still get infected. In any case, we don’t see severe forms of the disease in the very rare cases in which reinfection has been reported, ”Obieta explained.

Also viewed by Infobae, Gabriela Piovano, infectologist at Muñiz hospital, specifies: “The phenomenon of reinfection was already recorded during the first year of the SARS-CoV-2 virus epidemic., where health staff documented cases, where the second infection was more severe than the first. In some cases, the second episode had a greater clinical impact”.

“One of the reasons why many infections recorded, for example with the Manaus variant (called Gamma by the WHO), which were more severe in young people, may reflect that in Brazil in particular they were infected by the original variant that emerged in Wuhan China, then they made a reinfection with the strain Manaus (Gamma) and that is why we see worse developments ”.

According to Piovano, “the fact that they occur when people get vaccinated mainly reflects the increased circulation of the virus at the moment. We have seen the phenomenon that people who were going to be vaccinated were infected two or three days before or after, and in those cases, obviously, the vaccine does not perform its function.”.

“There is an X variant that escapes your immunity from the original or Wuhan variant. This is observed for example with HIV, where the person produces antibodies but they are not neutralizing, or maybe they can neutralize for a while but the infection continues to occur, and this is because the immunity that these patients naturally build up from the infection does not protect against some variants. So far the information is that vaccines are used for all variants. The fact is that many of those re-infected were not vaccinated“, He explained.

Jorge Levalle, doctor in infectious medicine at Pirovano hospital and member of the Argentinian Society of Infectious Diseases (SADI) said Infobae: “With regard to re-infections, one must be very careful when classifying a case as re-infection because to know whether it is indeed a re-infection or an infection of a new strain, because what to do is find out the genomic reinfection of the first infection and the genetic infection of the second and see if it is the same, or if it is from a different strain”.

“Reinfections are not very frequent, they are taken for granted as the pandemic continues, it may occur more frequently. And what yes, he has to do in this if it is corroborated, that if you have more than one strain by the time this occurs and these variants are highly infectious, it is likely that reinfection will occur», He alerted.

But to know, he insisted, reinfection or is it the same that has lasted over time, you have to study the genome of the virus and study it. It is spoken with little criterion of this. We cannot speak of reinfection in a patient who has had COVID and after two months they do a PCR and it tests positive because we do not know if these are non-infectious particles corresponding to the first infection or if it is again a reinfection. To find out, you have to do the genomic study. In any case, as we have already mentioned, the possibility of reinfection is always minimized with the vaccination and massive of what we do here ”, concluded Levalle.

According to Edgardo Bottaro, infectologist and medical coordinator of Helios Salud, “We should take into account several things: first to know if there are really so many cases. Keep in mind that the disease produces a certain degree of protection which can weaken over time. I’m not very clear if there are a lot of people who are suffering from the coronavirus now and that they had COVID-19 last year ”.

“Second, the true degree of protection of vaccines compared to new variants is not yet clear and third It seems to me that there is still little vaccination time and little coverage to see a drop in the immunity conferred by inoculation“He added.

Collaboration: Agustín Gallardo and Belén Filgueira

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