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COVID-19 reinfection tracker

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The table below shows confirmed cases of COVID-19 reinfection. The first confirmed case of reinfection was reported in Hong Kong on August 24, and 23 others were reported by mid-October. Earlier cases of suspected reinfection could not be confirmed due to a lack of data.

People with SARS-CoV-2, the virus which causes COVID-19, may continue to test positive for several months without being sick or infectious. A reinfection is confirmed when testing shows each virus’ genetic makeup is different to a degree which cannot be explained through in-vivo evolution.

For a timeline with detailed information about each case, scroll down.

Reporting on reinfections is limited. If you believe we have missed a case, please let us know by sending us an email at [email protected]. You can also reach us on Twitter by sending a DM to @BNODesk.

Definitions

  • Reported: The month in which the reinfection is publicly reported. Due to the amount of research required to confirm a reinfection, the actual case may have occurred weeks or months earlier.
  • Interval: The number of days between recovery from the first case and the onset of symptoms from the second case, if available. If not available, the number of days between positive tests.

Timeline

October 20

  • A probable case of reinfection has been reported in the Australian state of Victoria. The person tested positive on Monday after previously contracting the virus in July, but details about their symptoms – if any – were not immediately known. Premier Daniel Andrews, speaking at a press conference, said an expert panel reviewed the case and found there wasn’t enough evidence to say the positive test was caused by persistent viral shedding, which is why it’s being regarded as a reinfection. “The case is being managed very cautiously and further investigations are ongoing,” he said. (Source)
  • Washington state is investigating about 120 suspected cases of reinfection, according to the state’s health department, which confirmed the figure in response to questions from BNO News. All of the cases have at least 90 days between the two episodes but more research is needed to confirm or rule out reinfection. “We are not aware of any deaths,” the department said. It was not immediately known how many of the suspected cases will be subject to genomic sequencing. (Click here for the full response from the state’s health department)

October 19

  • Health officials in Brazil are investigating at least 247 possible cases of COVID-19 reinfection, according to CNN Brazil. All of the patients tested negative in between both episodes. It’s unknown how many of those cases will be subject to genomic sequencing to confirm or rule out reinfection. (Source)
  • A retrospective study of confirmed cases in Mexico found 258 suspected cases of reinfection, including 11 people who died. None of the cases were confirmed with genomic sequencing, which is one of our requirements, and thus none of them can be added to the tracker. The study defined reinfection by the reappearance of COVID-19 symptoms with an interval of at least 28 days. The median interval was 56 days and most were below the age of 50. Patients who were more seriously ill the first time were more likely to develop severe symptoms the second time, as well as those over the age of 50 or with chronic diseases, according to the study. (Source)

October 18

  • The reinfection in Sweden has been updated with new information (see below).

October 16

  • Researchers in Sweden have confirmed the country’s first case of reinfection. The patient is a healthy 53-year-old woman who tested positive in early May and again in late August, with a negative test in June, according to Dr. Johan Ringlander, from the Infectious Diseases Department at the University of Gothenburg. He said the woman suffered milder, cold-like symptoms the second time and did not require hospitalization. Low levels of antibodies were found after the second infection with a low viral load in the nasopharynx. (Source)

October 14

  • Researchers in Spain have confirmed the country’s first case of reinfection. The patient is Dr. Ramon Valls, a healthy 62-year-old rheumatologist in Girona, Catalonia. He first tested positive in March and suffered mild symptoms, including fatigue, fever, and loss of smell. He was reinfected in late August and was hospitalized with double pneumonia for a significant amount of time. Dr. Roger Paredes, who confirmed the reinfection with genomic sequencing, told BNO News that, using WHO classification, the reinfection can be classified as “critical.” The patient has since recovered. Dr. Paredes said his team will submit the data to a peer-reviewed journal on Thursday. (Source)

October 12

  • The reinfection in Nevada, which we first reported on August 28, has been peer-reviewed and published in The Lancet. Click here to read the full paper.
  • The first death from reinfection has been reported in the Netherlands. The patient was an 89-year-old woman with Waldenström’s macroglobulinemia who arrived at the emergency department earlier this year while suffering from fever and severe cough. She tested positive for coronavirus and remained hospitalized for 5 days, after which her symptoms subsided completely, except for some persisting fatigue. Nearly 2 months later, just two days after starting a new chemotherapy treatment, she developed a fever, cough, and dyspnea. When she was admitted to hospital, her oxygen saturation was 90% with a respiratory rate of 40 breaths per minute. She again tested positive for coronavirus. Tests for antibodies were negative at days 4 and 6. Her condition deteriorated on day 8 and she died two weeks later. Genomic sequencing supports reinfection. (Source)

    Click here to read the full article.

September 30

  • The reinfection in Washington state, which was first reported on September 26, has been updated with new information from Dr. Jason D. Goldman at Swedish Medical Center. Goldman said his team and other collaborators are still investigating other possible cases of reinfection.

    “We have seen a number of other possible reinfection cases at our hospitals, and others amongst our collaborators. We are currently investigating these cases to determine if they are in fact reinfections,” Goldman told BNO News. “We are organizing a larger case series to repeat some of the detailed immunological analyses performed in the case reported on medRxiv. We are happy to have other well-defined reinfection cases join our growing case series.”
  • Researchers in Belgium have confirmed two more cases of reinfection, according to journalist Dries De Smet from De Standaard newspaper. The first case is a 30-year-old general practitioner from Antwerp who tested positive in mid-March and again in early August. The second case is a 25-year-old woman with an interval of 115 days between both infections. Both patients suffered mild symptoms in both the first and second episode. They have since recovered. (Source)

September 29

  • Qatar has confirmed four cases of reinfection in the world’s largest study to date. The research team went through a database with more than 130,000 positive tests and found 15,808 people who had at least 2 positive tests. Those who had their second positive test within 45 days were excluded in this study, which left 243 suspected cases of reinfection. Fifty-four of those were deemed to have strong or good evidence of reinfection.

    Nearly all of the suspected cases were in men and young adults, which reflects the country’s epidemic as a whole and has resulted in limited mortality. 23 of the suspected cases were diagnosed at a health facility, which suggests the presence of symptoms, according to a preprint paper. The other 31 were found through random testing campaigns or contact tracing, which suggests minimal symptoms, if any.

    However, paired samples could be retrieved for only 23 out of the 54 cases which were deemed to have strong or good evidence of reinfection. Eleven of those were discarded because of low genome quality, and in six cases there was no genomic evidence to support reinfection. In two cases, there was conclusive evidence to rule out reinfection as both pairs of genomes were of high quality yet no differences were found.

    Conclusive evidence of reinfection was found in the remaining four cases, though none of them were hospitalized for either the first or second infection. Three of those were diagnosed at a health facility, but details about their symptoms, if any, are unknown. In one case, antibody test results were available at the time of reinfection, and the individual was sero-negative.

    The research team said the results were “striking” because Qatar’s outbreak is estimated to have infected up to half of the population. “It is all but certain that a significant proportion of the population has been repeatedly exposed to the infection, but such re-exposures hardly led to any documented reinfections,” they said.

    The team also pointed out that none of the confirmed reinfections in Qatar were severe or fatal. “These findings suggest that most infected persons do develop immunity against reinfection that lasts for at least a few months, and that reinfections (if they occur) are well tolerated and no more symptomatic than primary infections,” they said.

    Click here to read the full paper.

September 26

  • A third case of reinfection has been confirmed in the United States. It involves a person in their 60s who resides in a skilled nursing facility in the Seattle area and has a history of hypertension and severe emphysema with home oxygen, according to a preprint paper. The patient was hospitalized with severe pneumonia in early March and tested positive for coronavirus after contact with someone who returned from the Philippines with a respiratory infection. Other symptoms included fever, chills, productive cough, dyspnea, and chest pain. The patient returned to the facility after testing negative on days 39 and 41 of their hospitalization. Nearly 3 months later, the patient developed a dry cough and described feeling weak, which ultimately led to an ER visit two weeks later when the patient developed shortness of breath. The patient tested positive twice. “Fortunately for our patient, the reinfection was more mild than was the primary infection,” the authors said. The patient recovered after treatment with remdesivir and dexamethasone. (Click here to read the full paper)

September 23

  • Two reinfections in the Netherlands, which were first reported on August 26, have been updated with more information. Dr. Jean-Luc Murk, an expert in viral infections at Elisabeth-TweeSteden Hospital in Tilburg, said the cases at his hospital are different from the one in Hong Kong, which had more than 4 months between the two episodes. “In both cases, there is a second infection with a different virus variant which took place before the immune system could form a good / complete immune response,” Murk said in response to questions from BNO News. One of the cases in Tilburg had only 12 days between the two positive tests.
    Click here to read the full response from Dr. Murk

    Translation by BNO News with minor edits.

    Q: Age, sex, and any relevant underlying conditions
    A:
    Both male, 1st in his 80s with an extensive cardiac history, COPD and diabetes. The 2nd in his 60s with a blank history.

    Q: The number of days between the 2 infections and/or dates of the positive tests
    A:
    The infections happened in the months April-May. I don’t want to give exact data at this moment, I think that information is too specific. With the 1st patient, time between 2 positive tests = 23 days, with the 2nd patient = 12 days. In both cases, there is a second infection with a different virus variant which took place before the immune system could form a good / complete immune response. These are not reinfections like the case in Hong Kong, which had months in between.

    Q: Symptoms during the infections (or a description, for example mild or serious)
    A:
    1st person:
    – 1st episode: mild respiratory complaints as a result of SARS-CoV-2 – hospitalized due to another problem
    – 2nd episode: Mild respiratory symptoms again as a result of SARS-CoV-2 (please note: also consider COPD, so underlying illness), again hospitalized for another problem
    2nd person:
    – 1st episode: moderately severe respiratory symptoms as a result of SARS-CoV-2, also the reason for hospitalization
    – 2nd episode: serious respiratory symptoms, possibly direct result of the virus infection, but also other complicating factors (pulmonary embolisms)

    Q: Has the patient recovered?
    A:
    Both fully recovered

    Q: Have the reinfections in Tilburg been confirmed with genetic research, to exclude the possibility it concerns the same infection?
    A:
    Absolutely

    Q: Are any additional (suspected) cases known in Tilburg? If so, can you provide more information?
    A:
    No additional cases have come to light yet

  • Four additional cases of reinfection have been confirmed in India. It concerns three doctors and one nurse who were involved in the treatment of coronavirus patients in Mumbai. “For all four [healthcare workers], the second episode had more symptoms, with constitutional manifestations and illness that lasted longer than the first episode,” the researchers said in a preprint paper submitted to The Lancet. Two of the doctors were asymptomatic during the first episode and suffered mild symptoms during the second episode. The third doctor, a healthy 27-year-old man with mild symptoms during the first episode, experienced more intense symptoms during the second case. The nurse, a 24-year-old woman, suffered mild symptoms at first and more intense symptoms during the second bout, with symptoms lasting up to 3 weeks. Her antibody test, which was taken 19 days after the second infection, was negative. The interval between the two episodes is 60 days, 59 days, 13 days, and 48 days. (Source)
  • A second case of reinfection has been reported in the United States. It concerns a healthy 45-year-old man who works at a military hospital in Virginia. He first became ill on March 19 after a workplace exposure to coronavirus and suffered from mild symptoms, including cough, subjective fever, and myalgias. “Clinical resolution of illness occurred by day 10, and he returned to baseline excellent health for the following 51 days,” the researcher said in their report. ” Less than two months later, the man fell ill while someone in his household was suffering from COVID-19. “Notably, symptoms were significantly worse when compared to the initial syndrome,” the authors said. Symptoms included fever, cough, shortness of breath, gastrointestinal symptoms, high heart rate, high normal blood pressure, and pulmonary infiltrate. The patient recovered after 14 days of illness. (Source)

September 15

  • Scientists in India are reporting the first two genetically confirmed cases of reinfection. The cases, in a 25-year-old man and a 28-year-old woman, were detected during routine screening of healthcare workers at a hospital in northern India. There were 100 and 101 days between the two cases, respectively. “Both individuals were asymptomatic but had a higher viral load in the second episode of reinfection,” the team said in a pre-print paper, which added that asymptomatic reinfection may be under-reported. The team is investigating 6 other cases of reinfection in Mumbai and Delhi: Initial research has shown the viruses were genetically different in each episode, but additional research is pending. (Source 1, Source 2)

September 7

  • Reinfection cases have been reported in India over the past few days, but none have been scientifically confirmed. People with coronavirus may continue to test positive for several months without being sick or infectious. As a result, we only add cases in which the genetic makeup of each virus was shown to be different.

September 5

  • A new paper provides more information about the reinfection in a 51-year-old woman in Belgium. The case was first reported on August 24. (Source)

September 3

  • A paper from the Institute of Microbiology at the University of San Francisco Quito provides more details about the reinfection case in Ecuador. (Source)

September 1

  • A study in Iceland has found that antibodies against SARS-CoV-2 remain stable for at least 4 months, which is the period covered by the researchers. No antibodies were detected in a small number of cases, which suggests some people may produce no or undetectable levels of antibodies. or they received a false positive on their PCR test. Among people who recovered, antibody levels were higher in older people and those who were more severely affected by coronavirus. Smokers had lower levels of antibodies. (Source)

August 31

  • The case in Belgium, which was first reported on August 24, has been updated with more information. In an email to BNO News, virologist Marc van Ranst said the patient is a 51-year-old woman with no underlying conditions. She suffered mild symptoms during the first infection, including fever, cough, and shortness of breath, and was unable to work for 5 weeks. She suffered the same symptoms during the second infection but they were less intense and lasted for one week. There were 93 days between the two cases. (Source)

August 30

  • First case in Ecuador. The 46-year-old man from Quito tested positive in May when he suffered from mild symptoms, including a headache and fatigue. The patient returned in August while suffering from more serious symptoms, including a fever, chest pain, cough, and a sore throat, and again tested positive. The period between the two cases is 81 days. High levels of IgG antibodies were found after the second infection. The patient’s wife is a suspected case of reinfection, but there is insufficient data to confirm this. (Source 1, Source 2)

August 28

  • First case in the United States. A 25-year-old man from Reno, Nevada, tested positive for coronavirus in April and suffered mild symptoms. He tested negative on May 9 and continued to feel well until May 28, after which he developed serious symptoms. He again tested positive for coronavirus when he was hospitalized on June 5. Due to privacy laws, the research team was unable to comment on the patient’s current condition. (Source 1, Source 2)

August 26

  • Three more cases in the Netherlands. One is a nursing home resident who developed a second infection after 2 months. The other two cases are in Tilburg. The first case, a man in his 80s, suffered two bouts of mild symptoms with an interval of roughly 21 days. The second patient, a man in his 60s, had mild symptoms during the first infection but quickly recovered. The man returned several days later as he suffered from respiratory failure and again tested positive for coronavirus. According to Dr. Jean-Luc Murk, this could be a double infection or reinfection before the patient was able to build immunity. (Source 1, Source 2)

August 24

  • First case of reinfection in the Netherlands. (Source)
    Update (Oct. 13): This case was removed after a spokesman for the Dutch Institute for Public Health confirmed that a reinfection death reported on Oct. 12 was one of the cases which had previously been reported. This August 24 case is now listed as Oct. 12.
  • First case of reinfection in Belgium. A woman in her 50s tested positive for coronavirus in the second week of March, and then again in June. Details about her symptoms are unknown. The woman has recovered. (Source)
  • Hong Kong University has reported the first proven case of COVID-19 reinfection in a 33-year-old man. During the first episode, he suffered from cough and sputum, sore throat, fever, and headache for three days. He tested positive on March 26, 2020, and was discharged from hospital on April 14. Months later, on August 15, the patient tested positive again upon his return to Hong Kong from Spain via the UK.He was hospitalized but remained asymptomatic. (Source)
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