This article is updated daily.
The table below shows confirmed cases of COVID-19 reinfection. The first confirmed case of reinfection was reported in Hong Kong in late August, and 71 other cases were reported over the next few months, along with more than 40,000 suspected cases.
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.
The table below shows confirmed cases of reinfection. For a timeline with more details, scroll down to the bottom of this page. For a list of suspected and probable cases, click here.
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.
- Reported: The date on 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 not available, the number of days between positive tests.
- Researchers in Texas have confirmed the state’s first case of reinfection in a 16-year-old girl with end stage renal disease. The girl, who was hospitalized at Texas Children’s Hospital in Houston, suffered two symptomatic episodes in November 2020 and January 2021, with an interval of 94 days. The first episode was mild and she recovered from the illness in just over a week, according to the group of researchers. The second episode was more intense with severe mouth and throat pain, fever, and neutropenia. Genomic sequencing revealed the B.1.2 lineage in the first episode and the B.1.1.7 variant (also known as the UK variant) in the second episode. This is the first confirmed case of reinfection in the U.S. with the UK variant. (Source)
- On September 23, 2020, four reinfection cases from Mumbai, India, were added to the tracker. Three of those have now been removed because the study’s final version, using CDC criteria, confirmed reinfection in only one case, a 24-year-old woman.
In the other cases, one was determined to have “weak evidence” for reinfection, another was inconclusive because a prolonged infection could not be ruled out, and the third – which had an interval of just over 2 weeks – was excluded from the study.
The study’s final version also adds the case of a 51-year-old woman whose reinfection has been confirmed. This case was retroactively added to the tracker (see March 9 in the timeline).
- Researchers in Brazil have reported the country’s first confirmed death from COVID-19 reinfection. The case involves a 39-year-old man who was infected with the so-called Brazilian variant (P.1) in late November and the P.2 variant in mid-March.
The man, from Campo Bom in the southern state of Rio Grande do Sul, had a history of chronic cardiovascular disease and diabetes. He first tested positive on November 30 but details about his symptoms – if any – are unclear. Genomic sequencing revealed the P.1 variant.
The patient fell ill a second time about 3 months later and tested positive on March 11. His initial symptoms were fatigue and respiratory distress, but his condition worsened and he was transferred to the ICU, where he was intubated and died on March 19.
Genomic sequencing of the sample from the second episode revealed the P.2 variant, which is classified as a Variant of Interest.
“It is noticeable that P.1 and P.2 variants share at the typical E484K mutation in the RBD site, which has been related to antibody escape in patients previously immunized by non-mutated lineages,” the researchers said in a preprint of their study.
This is only the third time that someone has died from a confirmed case of reinfection with SARS-CoV-2 and the first time in Brazil. At least 38 other deaths have been reported among suspected cases worldwide, but the true figure is believed to be higher as research into reinfection remains limited. (Source 1, Source 2)
- Researchers in Germany have confirmed the country’s first case of reinfection in a 27-year-old nurse. The woman, who worked in a COVID-19 ward at University Medical Center Hamburg-Eppendorf (UKE), suffered two symptomatic episodes.
According to a paper published by the researchers, the woman developed fever, chills, and exertional dyspnea on March 18, 2020, and tested positive for COVID-19 two days later. The fever and chills resolved on March 25 but exertional dyspnea continued for 4 more weeks. She was also diagnosed with arterial hypertension.
Despite negative tests and the presence of neutralizing antibodies, the woman fell ill a second time at the end of the year. She developed a dry cough and mild rhinorrhea during the night shift of December 26 to December 27, and routine testing returned a positive result for SARS-CoV-2 later that day. Tests on December 28 and 29 were also positive. Her symptoms resolved by December 30. (Source)
- A reinfection cluster has been confirmed in Rio de Janeiro, according to researchers from the Oswaldo Cruz Foundation and the Federal University of Rio de Janeiro. It’s the result of a 10-month-long study during which 30 people, including households, were tested weekly for SARS-CoV-2.
Among the households in the study, a 54-year-old man (Patient A) requested a test for coronavirus on March 23, 2020, after having a recurrent headache for two days. He also reported having contact with a symptomatic co-worker who refused to be tested. Patient A’s test was positive.
A 57-year-old woman (Patient B) who had close contact with Patient A also tested positive and experienced mild diarrhea two days later. The woman shared a household with a married couple, both 34 years old, and they too had a positive test (patients C and D). Patient C was asymptomatic and Patient D reported diarrhea in the following days.
The samples from patients A and D were insufficient for genomic sequencing but patient B was found to be infected with emerging SARS-CoV-2 clade 19A and patient C with clade 20B. This suggests they contacted the virus independently and they did not infect each other.
About two months later, in the last week of May 2020, all four patients fell ill a second time. During this second episode, all four experienced worse symptoms when compared to the first time, including fever and cough, along with fatigue, headache, body ache, loss of smell, and loss of taste. Tests for coronavirus were positive and revealed higher viral loads when compared to the first infection.
“In the second episode, we fully sequenced the SARS-CoV-2 genome from all patients. SARS-CoV-2 sequences from the reinfection clustered together, suggesting a household transmission for patients A–D,” the researchers said. “The emerging genotype 20B, which was the main variant circulating in Brazil since May 2020, was detected in all samples from the second episode.”
Click here to read the full study.
- Santa Catarina in southern Brazil has reported the state’s first confirmed case of reinfection. The patient is a 30-year-old from Lages who tested positive in September 2020 and February 2021. Details about the patient’s illness were not released. The second episode involved the P.1 variant, which is also known as the Brazilian variant. (Source)
- Reinfection has been confirmed in a 47-year-old public service employee from Andhra Pradesh in India. The first episode was asymptomatic and was detected during routine surveillance on July 25, 2020. The second episode happened just over a month later when the man suffered from fever, cough and malaise. This case involves the N440K variant, which was also found in a reinfection reported on September 15, 2020. That case was asymptomatic as well. (Source)
- A case of reinfection has been confirmed in Connecticut, raising the number of confirmed cases in the U.S. to 12. The latest case involves a man between the ages of 60 and 70 who suffered two symptomatic episodes roughly 7 months apart.
The patient has a complicated medical history which includes end-stage renal disease, for which he had undergone living-donor renal transplantation in 2018. The man, who also has a psychiatric illness, tested positive for SARS-CoV-2 when he was hospitalized with fever, fatigue, and a dry cough in March 2020.
The illness was described as “moderate” with a need for supplemental oxygen, according to the preprint of a case study. The patient was transitioned to room air by day 13 of his illness and was asymptomatic thereafter, although he continued to test positive throughout his hospital stay. A test taken months later came back negative.
The patient was readmitted to hospital with fatigue and nonproductive cough about seven months after the initial episode. Repeated tests for coronavirus came back positive, the researchers said, but the case remained mild with no fevers, hypoxia, or evidence of pneumonia.
“Through extensive clinical investigation and phylogenetic analysis of virus sequences, we confirmed that the patient was reinfected with a genetically distinct lineage of SARS-CoV-2, which was neither the result of persistent infection nor the result of infection by an antigenically distinct SARS-CoV-2 variant,” the researchers said.
The researchers added that the patient had responded to the first infection with transient, poor-quality adaptive immune responses, and his immune system was further compromised by intervening treatment for acute rejection of the renal allograft.
“In this case study, we found that a failure of humoral immunity may have led to this patient’s SARS-CoV-2 reinfection,” the researchers said. They added that patients who are immunosuppressed may not develop sufficient protective immunity and are therefore at risk of reinfection.
Click here to read the full case study.
- Researchers in Colombia have confirmed the country’s first case of reinfection. It involves a 54-year-old woman who suffered two separate episodes of COVID-19 only a month apart. She has since fully recovered.
“This case showed consecutive infections with independent SARS-CoV-2 lineages, B.1 and later B.1.1.269, two of which were phylogenetically distant while also displaying six substitutions of difference,” the researchers said in a paper. The B.1 lineage is highly frequent in Colombia, but the B.1.1.269 variant had not yet been detected in the country. (Source)
- An eighth case of reinfection has been confirmed in Brazil. The case involves a 39-year-old woman from Curitiba, the capital of Paraná, who tested positive on June 15, 2020, and again on February 24, 2021. This puts the interval at 254 days.
Details about the woman’s condition were not released by Paraná’s health ministry. It said genomic sequencing showed a variant of the B.1.1.28 lineage in the first episode and the P.2 variant in the second episode. (Source)
- Reinfection has been confirmed in a 51-year-old woman who worked as a technician at a COVID-19 diagnostic laboratory in Mumbai, India. The first episode in May 2020 was mild but the reinfection in September 2020 was more intense and lasted much longer.
During the second episode, the woman suffered from fever, myalgia, dry cough, nausea, abdominal pain, and breathlessness on exertion. The fever lasted 8 days but breathlessness and fatigue persisted for more than 6 weeks. An HRCT of the chest revealed pneumonia and pulmonary fibrosis.
The study, from researchers at Kasturba Hospital, also describes a confirmed case of reinfection in a 24-year-old woman. This case was described in an earlier version of the same paper, which was added to the tracker on September 23. (Source)
- A second reinfection has been confirmed in Mexico. The 27-year-old woman worked as an intern at an IMSS hospital and was infected in late March and late May, with an interval of roughly 53 days.
The reinfection occurred despite a positive test for SARS-CoV-2 antibodies, according to the Milenio newspaper. Both episodes were described as very mild, with the reinfection being even milder and shorter. (Source)
- Researchers in Brazil have confirmed another case of COVID-19 reinfection. The patient is a 29-year-old male physician from Minas Gerais who suffered two mild episodes with an interval of 230 days, according to the Federal University of Ouro Preto (UFOP).
Researchers Alexandre Reis and Breno Bernardes de Souza said the first infection involved the B.1.1.28 variant, which has circulated in Brazil since March 2020. The second episode involved a B.1.2. variant which was found in the United States.
Reis pointed out that the new variant was not the only factor in the reinfection. “The fact that the patient’s antibody tests were negative, as well as other factors yet to be well understood, must also have contributed to the condition,” he said. (Source)
- Colorado has reported 5 confirmed cases of COVID-19 reinfection, raising the total in the United States to 11. Specific details about the confirmed cases were not immediately released.
According to the Colorado Department of Public Health, 822 cases meet the CDC’s criteria for possible reinfection, which represents 0.19% of the state’s total case count. The cases were reported from August 20 through February 28 and range in age from 1 to 101, with a median age of 42. Forty-nine percent is female.
Of the more than 800 suspected reinfections, paired samples were only available in 7 cases. “Of those seven, five were genetically different, representing true reinfection, the other two were not,” the health department said in a statement. It provided no specific details about the five confirmed cases.
We have reached out to the health department for more information. (Source)
- The Dutch Institute for Public Health (RIVM) tells BNO News that it will not release details about the number of reinfections. The last time RIVM provided an update on reinfections was in October 2020, when four such cases were confirmed in the Netherlands.
- Switzerland has reported the first confirmed case of COVID-19 reinfection. The case involves a 36-year-old physician in Geneva who suffered two mild cases nearly seven months apart.
The woman tested positive on April 10, 2020, during an active investigation into an outbreak at a hospital in Geneva. Although she was initially asymptomatic, she soon developed weakness and a headache lasting for two weeks, along with slight memory loss and difficulties concentrating when she resumed work.
The woman tested negative during another hospital outbreak in mid-October, but developed symptoms less than a week later while working in a COVID-19 ward. An RT-PCR test taken the next day was positive, as was a second test four days later.
Her symptoms during the second episode included weakness, shivering, rhinorrhea, loss of smell, arthralgia, headache and exertional dyspnea. All symptoms resolved within 10 days.
“Whole-genome sequencing identified two different SARS-CoV-2 genomes both belonging to clade 20A, with only one non-synonymous mutation in the spike protein, and clustered with viruses circulating in Geneva at the time of each of the corresponding episodes,” the researchers said. (Source)
- Another case of reinfection has been confirmed in India. The case involves a 61-year-old healthcare worker who tested positive on August 31, 2020, but remained asymptomatic. He complained of weakness during the second week of November and developed a cough two days later, which was followed by a positive test on November 14. Sequencing revealed the presence of 10 unique variations between the viral genomes of both episodes. (Source)
- Canada has reported the first confirmed cases of COVID-19 reinfection. The three cases in British Columbia were first reported by CTV News earlier this month, but at the time it was not clear if they met the criteria for confirmed cases.
“All three re-infection cases in BC were confirmed by whole genome sequencing,” Vincent Chou, a spokesman for the Provincial Health Services Authority (PHSA), told BNO News in an email. He declined to provide further details due to patient privacy. (Source)
- Panama has reported the country’s first confirmed case of COVID-19 reinfection. Dr. Juan Pascale, of the Gorgas Memorial Institute for Health Studies, said there was an interval of about 6 months between the two episodes. Other details were not immediately released. (Source)
- Researchers in New York have found the first confirmed case of reinfection in a child. The authors, who carried out a genomic study in the Bronx, found 2 suspected cases of reinfection: one was confirmed and the other was determined to be a case of persistent infection.
The reinfection involved a young girl between the ages of 10 and 15 who was initially examined at a hospital in April 2020 after 3 days of fever, sore throat, loss of smell, and loss of taste. She tested positive for COVID-19 and recovered from the illness after 6 days of symptoms.
“In August 2020, she presented again to the emergency department with two days of fever, severe postprandial abdominal cramps, watery diarrhea and generalized body aches,” the study authors wrote in a preprint, adding that she had been in general good health between the two episodes.
“A respiratory pathogen panel was negative but her SARS-CoV-2 RT-PCR was positive, as was her SARS-CoV-2 IgM Immune Status Ratio,” the authors said. “The patient had a total of three days of fever with complete resolution of all other symptoms by day four of illness.”
The authors sequenced two samples from the girl, taken 142 days apart, and found the genomes differed in nucleotide sequence at 17 different positions. “To our knowledge, this is the first case of symptomatic reinfection in a child who had prior symptomatic SARS-CoV-2 infection,” the authors said. (Source)
- Paraguay has reported the country’s first confirmed case of reinfection. It’s a 40-year-old man from Ñemby who was infected in July and a second time in November. Samples from both episodes were sent to a lab in Brazil, where sequencing confirmed reinfection.
A statement from the health ministry said both episodes were mild and the patient did not require hospitalization. Neither episode involved the UK, Brazilian, or South African coronavirus variants. (Source 1, Source 2)
- Two more reinfections have been confirmed in the Brazilian state of Amazonas. Both were reinfected with the B.1.1.28 subclade variant, which is also known as P.1 or the Brazilian variant.
The state’s health department said the cases involve two women aged 50 and 40 who were reinfected after 92 and 282 days, respectively. Both have since recovered. (Source)
- California has reported the first confirmed cases of COVID-19 reinfection. Corey Egel, a spokesman for the California Department of Public Health, confirmed the news in response to questions from BNO News.
“The state has confirmed two cases where individuals have been reinfected with COVID-19,” Egel told BNO News. “In order to protect patient privacy, CDPH cannot provide additional details about these situations or individuals.”
In response to follow-up questions, the health department said the interval between infections was “greater than four months” in both cases. The patients had symptoms during both episodes of infection.
Egel pointed out that reinfection is rarely reported. “Nevertheless, it is important to recognize that reinfection can happen, and that everyone needs to take steps to prevent the spread of disease, including people who have had COVID-19 in the past,” Egel said.
Other details about the two confirmed cases have not been released.
Earlier this month, Monterey County reported that one person had been reinfected with the 452R coronavirus variant, but it’s unclear if samples from both episodes were examined to confirm reinfection. Monterey County has not responded to follow-up questions and Egel declined to provide details about the two confirmed cases.
- Researchers in China have confirmed six cases of reinfection during a study into 273 people who were admitted to Beijing Ditan Hospital in the early stages of the pandemic. This revealed 28 suspected cases in which someone tested positive at least twice during follow-up.
The researchers were able to retrieve paired samples from seven of the suspected cases and performed genomic sequencing to confirm six reinfections. In the seventh case, the genomes were found to be from the same lineage, which makes reinfection unlikely.
“Five of these six pairs sampled in the second episode were found to be D614G mutants,” the authors said in their study. “This variant was almost completely absent in China prior to March, and was identified as the predominant variant in Europe, gradually becoming frequent worldwide toward the end of March.”
The reinfections involve a 2-year-old child and 5 adults between the ages of 33 and 84. All of them had at least 2 negative tests between the two episodes (in one case, the patient tested negative 12 times before reinfection). None had autoimmune diseases, cancer, or a history of immunosuppressive drug use.
The interval between episodes, as measured from recovery until reinfection, ranged from 19 to 57 days, which is well below the average. Two of the cases were in critical condition during the first episode while the other four were described as “moderate.” The reinfection was mild in at least three cases and all six recovered.
Click here to read the full study.
- More than 4,300 suspected cases of reinfection have been recorded in South Africa as of January 6, according to Professor Koleka Mlisana of the National Health Laboratory Service. All of the cases had at least 90 days or longer between positive tests.
“A total of 4,326 potential re-infections have been recorded in the laboratory data analysis, including both the private and the public lab data,” Mlisana told BNO News. “This is laboratory data and no clinical or mortality data is available on these cases as yet.”
Mlisana provided the more specific figure after she talked about reinfection at a press conference on Monday night. She said there is currently no evidence to suggest that the South African coronavirus variant is causing a spike in reinfections.
“We are not necessarily seeing an increase in the risk of reinfection,” Mlisana said. “So far we are able to say there is no evidence that suggests that the risk of reinfection is increasing as a result of the new variant, but bear in mind that we are only talking a month so far (with data up until January 6), so this is an area that we need to look at very closely.”
(Source 1, Source 2)
- Germany has reported the first suspected death from COVID-19 reinfection. Local officials confirmed this after BNO News received a tip over the weekend which said a 72-year-old man had died from reinfection.
The case involves a man from Baiersbronn in the southern state of Baden-Württemberg who tested positive on April 4 and recovered with no signs of Long COVID. He developed new symptoms on New Year’s Eve and tested positive three days later before he died at a local hospital on January 11.
“The patient died of COVID-19 pneumonia and sepsis with multiple organ failure,” Stefanie Paprotka, a spokeswoman for Regional Council Stuttgart, told BNO News. “The course of the disease was consistent with a reinfection caused by SARS-CoV-2.”
Paprotka said it had not been possible to sequence a sample from the patient, but a sample taken from his wife showed it did not involve any of the newly-discovered coronavirus variants.
There are no public figures about reinfections in Germany, making this one of the first known suspected cases and the first death. For Paprotka’s full answers, click here.
- Five more reinfections were confirmed during a study in Qatar into people who were confirmed to have coronavirus after previously testing positive for SARS-CoV-2 antibodies. The study found that, among 43,044 people who were positive for antibodies between April and December, 314 had a positive PCR test after an interval of at least 14 days, suggesting reinfection.
Upon further review, only 129 cases were determined to have good or some evidence of reinfection, including 62 cases with records indicating prior diagnosis. Paired PCR samples were retrieved in 23 of those cases, but seven were discarded because of low genome quality. In seven other cases there was not enough evidence for reinfection because there were only minor changes in the genome and in four cases there was strong evidence for no reinfection.
“For four other pairs, there were multiple clear changes of allele frequency indicating strong evidence of reinfection,” the authors said in a preprint. “One of the latter pairs also documented the presence of the D614G mutation at the reinfection swab – a variant that has progressively replaced the original D614 form.” Evidence supporting reinfection was also found in a fifth case.
The five confirmed cases involve four people in their 30s and a woman in her 40s, according to the study, which was led by Professor Laith J. Abu Raddad. Details about their symptoms are limited, but a woman in her late 30s was asymptomatic in both episodes and a man in his early 30s suffered severe illness on both occasions. No deaths were reported.
1. Full prepreint
2. Table with details about each case
- Brazil has reported another case involving reinfection with a new coronavirus variant. The case involves a 29-year-old woman from Manaus in the state of Amazonas who tested positive on March 24 and a second time on December 30, which is currently the longest interval between episodes among confirmed cases. The woman suffered mild symptoms during both episodes and has since recovered.
According to Brazil’s health ministry, genomic sequencing showed that the woman was reinfected with the B.1.1.28 subclade variant, which was recently identified in four travelers from Brazil during routine screening at Tokyo International Airport. The new variant is assumed to have emerged in the state of Amazonas and has 12 mutations in the spike protein, including N501Y and E484K. This has raised concern about the potential for increased transmissibility, immune escape, and vaccine evasion. This is still being studied. (Source 1, Source 2, Source 3, Source 4)
- England has reported the first confirmed case of reinfection with the “more contagious” coronavirus variant which was first discovered in the UK. According to David Harrington, who works at the NHS in London, the case involved a 78-year-old man with significant underlying health conditions, but with no history of immunosuppression.
The man presented with fever while undergoing haemodialysis on April 2 and tested positive for COVID-19, but was discharged home and had an uneventful recovery. He continued to be routinely tested while undergoing haemodialysis and tested negative 22 times between May 5 and December 1. Antibodies were detected on 6 occasions between May 5 and December 1 with no evidence of antibody waning.
The patient developed shortness of breath in mid-December and he was rushed to hospital on December 14 when his condition worsened. “He was brought in by ambulance in extremis, very short of breath and unable to talk, with severe hypoxia, leading to emergency intubation,” Harrington said. The man was admitted to ICU with severe pneumonia, which was complicated by a heart attack. The man’s current condition has not been released.
“The [whole genome sequencing] results confirm reinfection with a different lineage 8 months after initial infection in the absence of significant immunocompromise. The reinfection was with the ‘new variant’ VOC202012/01,” Harrington said. He noted that the variant has raised questions about possible immune escape and vaccine evasion, but emphasized that more research is needed. (Source)
- Brazil has reported a reinfection involving the E484K mutation, which is also found in the coronavirus variant which was first detected in South Africa. The patient is a 45-year-old female healthcare worker from Salvador, the capital of Bahia state, and has no underlying health conditions. After going through a mild episode in May-June, she suffered a second episode in late October with more intense symptoms. Genomic sequencing found that the reinfection involved the E484K mutation, which has raised concern among researchers who say there’s a possibility it could escape some people’s immune response. (Source 1, Source 2)
- Sheba Medical Center has reported Israel’s first confirmed case of reinfection. The patient was a 74-year-old man who became ill in August and eventually recovered, which was followed by 3 negative tests. He became ill a second time, with symptoms including respiratory distress, when his geriatric care facility was hit by an outbreak of COVID-19. He was hospitalized and died in late November, making this only the second death worldwide from a confirmed case of reinfection. This case was previously on our list of suspected cases and has now been confirmed with genomic sequencing. We have reached out to the researcher, Prof. Galia Rahav, for more details about the man’s illness. (Source)
- Mexico has confirmed the country’s first case of reinfection. Only few details have been released, but the National Institute for Public Health said genomic sequencing was used to confirm reinfection. The patient from Guerrero fell ill on June 5, tested positive on June 8 and June 18, and recovered by the end of the month. He fell ill a second time on September 3 and once again tested positive for coronavirus. We have reached out to the institute to request more information about the man’s illness. (Source)
- Health officials in the Brazilian state of São Paulo have confirmed the country’s second case of reinfection. The patient, a 41-year-old nursing assistant from Fernandópolis, became ill and tested positive in June, only to fall ill a second time in November, with an interval of 145 days. Details about her illness have not been released, but a statement from São Paulo’s health ministry said the woman is alive. (Source, Source 2)
- Peru’s health ministry has reported the country’s first confirmed case of COVID-19 reinfection. The patient is a 6-year-old girl with Down syndrome and leukemia, which likely made her more vulnerable to reinfection.
The child fell ill with COVID-19 on April 8 and suffered mild symptoms, including fever and body aches, until she recovered. The second episode began on July 20 and included symptoms such as fever, general discomfort, and rapid breathing.
Peru’s National Institute of Health has so far identified 27 suspected cases of reinfection, but paired samples for genomic sequencing were recovered in only four of them, including the child’s case. The results from the other three cases were inconclusive. (Source)
- Brazil has reported the first confirmed case of COVID-19 reinfection. The health department in the eastern state of Paraíba says the patient is a 37-year-old healthcare worker who tested positive in June and October with an interval of 116 days. She had no pre-existing conditions and suffered mild symptoms in both episodes. Genomic sequencing of both samples confirmed reinfection. (Source)
- Apparent reinfections have been reported in Paraguay, including cases which resulted in death, the health ministry says. The number of cases and deaths was not immediately clear, but an earlier report in mid-November said at least 10 cases had been reported.
“We have cases of reinfection, and although there are few, they are serious with some of them dying,” said Dr. Guillermo Sequera, the general director of health surveillance. Some of the samples were sent to foreign labs for further analysis. (Source 1, Source 2)
- The number of suspected cases in Washington state has risen to 355, up from 120 in late October. “Further laboratory investigation of these cases requires that we have paired specimens available (one from each episode) with sufficient viral load,” Ginny Streeter, a spokeswoman for the state’s health department, told BNO News in response to an inquiry. “Note that < 5% of possible COVID-19 reinfections eligible for public health investigation as described above have paired specimens available for sequencing.” (Source)
- Researchers in South Korea have reported the first confirmed case of COVID-19 reinfection. The patient is a 21-year-old woman with a history of allergic rhinitis who was otherwise healthy. Unlike other confirmed cases, the woman had 3 symptomatic episodes in rapid succession, although the third episode may have been linked to the initial infection.
The researchers used whole genome sequencing to confirm that the woman had two different variants of the virus in the first and second episode. The first variant was dominated by genomes which were found during the Daegu outbreak in South Korea in late February and early March, while the second variant began to circulate in South Korea in early April, which matches the timeline in this case.
The woman’s first episode began on March 5 when she reported having a sore throat and cough with a small amount of sputum, and the symptoms persisted for a week. She tested positive on March 11 and was admitted to hospital. Her mild symptoms nearly disappeared by the 15th day of her hospitalization and she tested negative on March 26 and March 27. She was discharged from the hospital on March 30 when she had only residual upper airway symptoms such as nonproductive cough and a sore throat.
Just six days later, on April 5, the patient reported aggravation of cough combined with sputum, and a test for coronavirus the next day came back positive. “The patient had mild signs and symptoms as was the case at the time of the initial infection,” the researchers said. Her symptoms were nearly gone on the 4th day of the second hospitalization and she tested negative on April 17 and April 19. She was discharged from the hospital on April 25.
Yet five days after being discharged, during a period of self-quarantine, the woman reported having a sore throat and cough with sputum. Upon visiting the hospital, she once again tested positive. “We additionally performed whole-genome sequencing of this clinical sample at positive retest, but the sequence reads were rarely mappable,” the researchers said, adding that there was some evidence linking it to the initial infection.
“This finding implies that the positive retest at the patient’s third admission might be due to prolonged clearance of the vital gene fragments of the initial infection. The patient’s symptoms subsided the day after admission, and she remained asymptomatic thereafter,” the researchers said. Tests on May 4 and May 6 were negative for coronavirus, and she was discharged on May 11.
To read the full study, click here.
- Sweden is investigating 150 possible cases of reinfection, according to Dr. Karin Tegmark Wisell of the Public Health Agency. “These 150 cases are at this stage only cases where additional laboratory findings with a positive SARS-CoV-2 PCR-test has been recorded for a second time more than 3 months apart,” Tegmark Wisell told BNO News.
Dr. Mia Brytting said more data is expected within four weeks. “We have just started to contact the laboratories concerning these cases,” she said. “If any of these cases have two samples with sufficient viral load for whole genome sequencing, [it will] be done.”
Tegmark Wisell added that the Public Health Agency has not yet decided whether suspected or confirmed reinfections will be counted as new cases. So far, only one reinfection has been confirmed in Sweden.
- Researchers in Belgium have reported the country’s fourth confirmed case of COVID-19 reinfection. It involves a healthcare worker in her 30s who was first infected in March and suffered a mild but protracted illness with cough, dyspnea, headache, fever, and general malaise. She slowly resumed work after 1 month.
The woman, who was described as immunocompetent, was re-infected as part of an outbreak which infected several people at the hospital where she worked. “During the second episode her clinical presentation was milder, and she resumed work 10 days after diagnosis although she experienced dyspneic spells for up to 3 weeks,” the researchers said.
The team notes that the woman was re-infected despite having developed a neutralizing antibody response following the first infection. “If cases like this substantially increase over the next few months, long-lived protective immunity against SARS-CoV-2 will not be likely, which would be in line with other human coronaviruses, and might impact current vaccine development strategies which are based on eliciting neutralizing antibody responses,” the team said in a preprint paper. (Click here to read the full paper)
- South Dakota is investigating 28 possible cases of reinfection, according to state health officials. A spokesman for the health department did not immediately respond to a request for more information. (Source)
- 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)
- 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)
- The reinfection in Sweden has been updated with new information (see below).
- 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)
- 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)
- 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.
- 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)
- 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.
- 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)
- 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
– 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?
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
- 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)
- 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)
UPDATE (March 9, 2021): The final version of this study confirmed reinfection in only one case, the 24-year-old woman. Of the other cases, one was determined to have “weak evidence” for reinfection under CDC criteria, the second was inconclusive because a prolonged infection could not be ruled out, and the third – with an interval of just 2 weeks – was excluded from the study.
- 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)
- 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.
- 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)
- A paper from the Institute of Microbiology at the University of San Francisco Quito provides more details about the reinfection case in Ecuador. (Source)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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)