Delhi: Two peculiar COVID reinfection cases spark debate over longevity of antibody

The patients include a man with a co-morbidity and a healthcare staff of the hospital itself. As per the hospital, the man was found to be reinfected in mere 25 days of testing negative from the first attack of the COVID-19.

However, the staff was found to be reinfected within two months of the recovery from the previous episode. The disease severity was found to be in the mild category in both episodes.

Surprisingly, the antibodies developed after the first infection were also found at a negligible level in the patients.

Also Read: First case of reinfection: Sion Hospital doctor fights COVID battle once again in Mumbai

Dr. Atul Kakar, Senior consultant and Vice-chairman of the Department of Medicine informed IANS that the antibody levels were either negligible or totally absent in the body of the two patients since they tested negative for the antibodies.

The first patient, who is in his middle age with an underlying condition of diabetes mellitus, was found reinfected within a month of testing negative for the disease. The patient had liver involvement due to alcohol and renal involvement due to diabetes.

"He had nasal discharge and was subsequently found to have fungal infection of sinuses (mucormycosis) in addition to COVID-19 infection (RT PCR).A He was treated with antifungal and other supportive medications and about 10 days later he was tested negative for Covid and discharged home. He was readmitted due to abdominal distension 25 days later and required hospitalization during which he was retested and found COVID 19 positive," informed Dr Kakar.

The second case is of the healthcare staff of the hospital. She was tested positive for COVID-19 in August and retested positive for the disease in October.

"She was initially admitted to the Covid facility for 3 days but later shifted to home isolation for 17 days in view of mild nature of her illness. On August 23, she rejoined work at the hospital after testing negative. In October, she developed a fresh episode of cough, generalised weakness and malaise. On October 28, the patient was investigated and was found to be COVID-19 positive once again. She was readmitted in the Covid facility and tested negative in few days after being diagnosed," Dr Kakar said.

"During the course, the patient was tested for COVID-19 antibodies but her antibody levels were negative," he added.

However, when asked whether the CT value was recorded during the investigation in both the cases during the first episode and the claimed reinfection, Dr Kakar said that the hospital considered it inconsequential during the re-infection.

"Both these cases follow the defined criteria of re-infection. However, in ideal circumstances, gene sequencing should have been done in both the cases," he added.

Dr Kakar also said that the re-infection with COVID was considered a rare possibility so far. However, it may start happening with the patients who recovered with the mild form of the viral disease.

"During recovery from Covid-19 infection most patients develop antibodies against COVID after 1 to 3 weeks from onset of symptoms. The development of these antibodies depends on multiple factors including the severity of the infection and the patient's immune response to the infection. Thus a patient who has mild disease may not mount a good immune response and may not develop antibodies," he explained.

Dr. Kakar also cautioned that the patients who recovered from the COVID-19 should continue precautions like social distancing, hand washing and wearing a mask in public places to avoid such re-infections.

Dr Suranjit Chatterjee, senior consultant, Internal Medicine, Indraprastha Apollo Hospitals, concurred with Ganga Ram Hospital's observation regarding patients with mild severity of Covid-19 but cautioned that one needs to be sure before categorizing the instances.

"We have been reporting cases where antibodies are not found after a period of recovery from Covid. However, it's too nuanced to categorise the patients who come with re-onset of the COVID symptoms after recovery as reinfection," he stated.

"Whether it's a reinfection or a relapse, it should be a subject of study," Dr Chatterjee added.

Also Read: Bombay HC restrains State from acting against 28 private hospitals on COVID Rates