Recurrence of COVID-19: Treading the Fine Line Between Relapse and Re-infection

  • Ritwick Mondal Department of Internal medicine , Institute of Post Graduate and Medical Education and SSKM Hospital, Kolkata, India
  • Shramana Deb S.N. Pradhan Centre for Neurosciences , University of Calcutta, India.
  • Durjoy Lahiri Bangur Institute Of Neurosciences , Institute of Post Graduate and Medical Education and SSKM Hospital, Kolkata, India
  • Gourav Shome Department Of Microbiology, University of Calcutta, India
Keywords: COVID-19, Relapse, Reinfection

Abstract

The ongoing outbreak of COVID-19 that began in Wuhan, China, has constituted a Public Health Emergency of International Concern, with cases confirmed in more than 200 countries. Currently, infected individuals are the primary source of infection and multiple cases of relapse are also reported following the recovery. It is highly concerning the nature of relapse which may be caused due to reactivation or reinfection. While the present testing scenario of using different molecular techniques has several loopholes that can report false results and hamper the process of effectively preventing the transmission of the virus. Various recommendations need modifications to effectively stop the horizontal transmission of the virus and look deeply into the links with relapse cases to prevent a second wave during a pandemic.

Author Biographies

Ritwick Mondal, Department of Internal medicine , Institute of Post Graduate and Medical Education and SSKM Hospital, Kolkata, India

MBBS. Junior Resident doctor.

First class MBBS graduate from Institute of Postgraduate and Medical Education and SSKM Hospital, Kolkata, India. He is currently engaged as a Junior Resident Department of Internal Medicine at the above institution. He has received various notable awards like ICMR-STS, international ambassador for the UMCG, Groningen etc. He is currently exposed to laboratory research at Bangur institute of Neurosciences.

Shramana Deb, S.N. Pradhan Centre for Neurosciences , University of Calcutta, India.

MSc.

Durjoy Lahiri, Bangur Institute Of Neurosciences , Institute of Post Graduate and Medical Education and SSKM Hospital, Kolkata, India

MD, DM. Senior Resident Doctor at the institute and faculty for PG courses. 

Gourav Shome, Department Of Microbiology, University of Calcutta, India

MSc. Currently Working as Junior Research fellow at the Department of Microbiology. Holds ICMR and CSIR JRF qualifications.

References

Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr. 2020 Apr;87(4):281-6.

Li X, Ma X. Acute respiratory failure in COVID-19: is it "typical" ARDS? Crit Care. 2020 May 6;24(1):198.

Worldometer. COVID-19 CORONAVIRUS PANDEMIC Available from: https://www.worldometers.info/coronavirus/. Last updated Sep 3 2020; cited Sep 3 2020

World Health Organization. Criteria for releasing COVID-19 patients from isolation. Available from: https://www.who.int/news-room/commentaries/detail/criteria-for-releasing-covid-19-patients-from-isolation. Last updated Jun 17 2020; cited Jul 3 2020.

Jiang M, Li Y, Han M, Wang Z, Zhang Y, Du X. Recurrent PCR positivity after hospital discharge of people with coronavirus disease 2019 (COVID-19). J Infect. 2020 Jul;81(1):147-78.

NPR News, npr.org. In South Korea, A Growing Number Of COVID-19 Patients Test Positive After Recovery. NPR Coronavirus Live Updates. Available from: https://www.npr.org/sections/coronavirus-liveupdates/2020/04/17/836747242/in-south-korea-a-growing-number-of-covid-19-patients-testpositive-after-recover. Last updated 17 Apr 2020; cited 3 Jul 2020.

Anwar H, Khan QU. Pathology and Therapeutics of COVID-19: A Review. Int J Med Students. 2020 May-Aug;8(2):113-20.

Xie C, Lu J, Wu D, Zhang L, Zhao H, Rao B, et al. False negative rate of COVID-19 is eliminated by using nasal swab test. Travel Med Infect Dis. Sep-Oct 2020;37:101668.

Channappanavar R, Fett C, Zhao J, Meyerholz DK, Perlman S. Virus-Specific Memory CD8 T Cells Provide Substantial Protection from Lethal Severe Acute Respiratory Syndrome Coronavirus Infection. J Virol. 2014 Oct;88(19):11034-44.

Chaturvedi R, Naidu R, Sheth S, Chakravarthy K. Efficacy of Serology Testing in Predicting Reinfection in Patients With SARS-CoV-2. Disaster Med Public Health Prep. 2020 Jun 24;1-3.

Enjuanes L, Zuñiga S, Castaño-Rodriguez C, Gutierrez-Alvarez J, Canton J, Sola I. Molecular Basis of Coronavirus Virulence and Vaccine Development. Adv Virus Res. 2016;96:245-286.

Petrosillo N, Viceconte G, Ergonul O, Ippolito G, Petersen E. COVID-19, SARS and MERS: are they closely related?. Clin Microbiol Infect. 2020 Jun;26(6):729-34.

Zhang D, Guo R, Lei L, Liu H, Wang Y, Wang Y, et al. COVID-19 infection induces readily detectable morphologic and inflammation-related phenotypic changes in peripheral blood monocytes. J Leukoc Biol. 2020 Oct 11;10.1002/JLB.4HI0720-470R.

Elberry MH, Ahmed H. Occult SARS-CoV-2 infection; a possible hypothesis for viral relapse . Med Hypotheses. 2020 Nov;144:109980.

Brufsky A. Distinct viral clades of SARS-CoV-2: Implications for modeling of viral spread. J Med Virol. 2020 Sep;92(9):1386-90.

Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents. 2020 Jun;55(6):105948. Epub 2020 Mar 19. Erratum in: Int J Antimicrob Agents. 2020 Sep;56(3):106-37.

Ye G, Pan Z, Pan Y, Deng Q, Chen L, Li J, et al. Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation. J Infect. 2020 May;80(5):e14-e17.

Traylen CM, Patel HR, Fondaw W, Mahatme S, Williams JF, Walker LR, et al. Virus reactivation: a panoramic view in human infections. Future Virol. 2011 Apr;6(4):451-63.

Chu H, Chan JF, Yuen TT, Shuai H, Yuan S, Wang Y, et al Comparative tropism, replication kinetics, and cell damage profiling of SARS-CoV-2 and SARS-CoV with implications for clinical manifestations, transmissibility, and laboratory studies of COVID-19: an observational study. Lancet Microbe. 2020 May;1(1):e14-e23.

Ganyani T, Kremer C, Chen D, Torneri A, Faes C, Wallinga J, et.al Estimating the generation interval for coronavirus disease (COVID-19) based on symptom onset data, March 2020. Euro Surveill. 2020 Apr;25(17):2000257.

He X, Lau EHY, Wu P, Deng X, Wang J, Hao X et.al Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020 May;26(5):672-675. Epub 2020 Apr 15. Erratum in: Nat Med. 2020 Sep;26(9):1491-93.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et.al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. Erratum in: Lancet. 2020 Mar 28;395(10229):1038.

Hindson J. COVID-19: faecal-oral transmission?. Nat Rev Gastroenterol Hepatol. 2020 May;17(5):259.

Agarwal S, Mistry H. Clinical Course of a Covid-19 Patient with Gastrointestinal Symptoms- A Case Report. Int J Med Students. 2020 May-Aug;8(2):148-51.

Xia J, Tong J, Liu M, Shen Y, Guo D. Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS-CoV-2 infection. J Med Virol. 2020 Jun;92(6):589-94.

Published
2020-12-09
How to Cite
Mondal, R., Deb, S., Lahiri, D., & Shome, G. (2020). Recurrence of COVID-19: Treading the Fine Line Between Relapse and Re-infection. International Journal of Medical Students, 8(3), 311-313. https://doi.org/10.5195/ijms.2020.727
Section
Letter to the Editor