Reports shed more light on COVID reinfection as 2 trials paused

As the pandemic total closes in on 38 million cases, researchers in the United States detailed North America's first known reinfection case as media reports from the Netherlands noted the first known instance of a fatal reinfection.

In other developments, Johnson & Johnson announced a paused in its COVID-19 vaccine study to probe an unexplained event in one of the participants, and Eli Lilly said it paused a monoclonal antibody trial to evaluate safety issues.

More reinfection reports, including a fatal case

The reinfection case in the United States is the first peer-reviewed report an repeat illness in an American, a 25-year-old Nevada man whose second COVID-19 infection was first reported in the media in late August.

Writing in The Lancet Infectious Diseases, researchers from Nevada said the Washoe County man who had no underlying health conditions tested positive for SARS-CoV-2 twice, once on Apr 18 and again on Jun 25, separated by two negative tests. The man's second infection was more severe requiring hospitalization and oxygen support. Genetic analysis of the viruses involved in each infection showed significant differences.

The team noted that some of the few other documented reinfection patients from other parts of the world had more severe disease the second time, which could stem from a variety of reasons, including a very high infectious dose for the second infection, a more virulent virus, or antibody-dependent enhancement. Continuous or coinfections are remote possibilities, they added.

They concluded that their findings have implications for vaccination, given that initial exposure to the virus might not result in immunity that is 100% protective and that more research is needed to determine how often reinfections occur.

In a related commentary in the same issue, Akiko Iwasaki, PhD, an immunobiologist with the Yale University School of Medicine, wrote that new report adds rapidly growing evidence of reinfection and also raises questions about immunity. She also said it's important to note that the cases are being picked up because of symptoms and are biased toward detecting symptomatic reinfections, which could underestimate asymptomatic ones.

In a related development, researchers from the Netherlands recently reported the first known death in a patient reinfected SARS-CoV-2, an 89-year-old woman who was undergoing chemotherapy and whose COVID-19 infections occurred 59 days apart. They detailed the case in a letter published on Oct 9 in Clinical Infectious Diseases. She was hospitalized for 5 days for her first infection, but other than some persistent fatigue, her symptoms subsided.

Symptoms of her second infection occurred 2 days into a new chemotherapy treatment. Researchers noted that she didn't have antibodies 6 days after the start of her second infection, and she died 2 weeks after she got sick with the second infection.

A reinfection tracker from BNO Newsroom shows that 23 reinfection cases have been reported across the globe, 1 of them fatal.

Pauses for vaccine study, monoclonal antibody trial

In vaccine and treatment developments, Johnson & Johnson announced yesterday that it has temporarily paused its COVID-19 vaccine trials due to an unexplained illness in a study participant. The independent data safety monitoring board for the phase 3 study and physicians from Johnson & Johnson are reviewing the illness, the company said in a statement.

They said they would share more information after they learn more about the participant's illness.

The pause is the second announced for a COVID-19 vaccine candidate. In September, AstraZeneca temporarily paused a trial of its COVID-19 vaccine to examine symptoms of transverse myelitis in one of the participants.

Also today, Eli Lilly paused a trial of its monoclonal antibody treatment for COVID-19 due to possible safety concerns, CNBC reported. A company spokeswoman told the network that an independent data safety monitoring board recommended the pause to ensure the safety of participants. The company recently announced that it submitted an emergency use authorization request for its LY-COV555 monoclonal antibody for treating mild-to-moderate COVID-19 infection.

In other US headlines:

  • Two new polls shed light on now the pandemic is impacting American lives, with one from NBC News/SurveyMonkey revealing that nearly three-quarters of US adults say that pandemic had major impact on their lives, with racial minorities and low-income respondents more likely to say the disruptions were "very major." Another poll from Associated Press-NORC Center for Public Affairs Research found that about 10% of Americans have become caregivers since the pandemic began, half providing care specifically because of the pandemic.

  • In Wisconsin, a judge yesterday upheld an order from Gov Tony Evers declaring a public health emergency and requiring that masks be worn in enclosed spaces, the Wall Street Journal reported. The challenge came from three residents of the state, which is currently experiencing a surge in infections.

  • The United States yesterday reported 41,653 new cases and 317 more deaths, according to the Johns Hopkins online tracker. The latest information from the White House coronavirus task force shows that 26 states are in the red zone for test positivity, up from 24 the week before, a reporter from Public Integrity revealed on Twitter today. The rest are in the yellow zone, and none are in the green zone.

Europe surge prompts new round of restrictions

Europe's second surge in cases saw no let-up today, with countries reporting more record daily high and others announcing tightened restrictions.

The Netherlands reported more than 7,000 cases, marking another in a series of daily highs, with Russia reporting nearly 14,000 cases, also a record high mark for its COVID-19 cases.

The Czech Republic, which currently has Europe's highest illness rate, announced that it was closing schools, bars, and dine-in service at restaurants for 3 weeks to curb the spread of the virus, the BBC reported.

Meanwhile, Italy today imposed new restrictions on gatherings, restaurants, and sports and school activities, which take effect tomorrow and last for 30 days, Reuters reported. The measures also require masks in homes when non-family members are present. Italy's cases doubled last week, and the country was one of Europe's hardest hit during the first COVID-19 wave in the spring.

Elsewhere in the world, China reported no new cases in a cluster of cases linked to a hospital in Qingdao, and the country's National Health Commission said an effort to test the city's whole population has found no other infections among the 1 million samples that have been processed so far.

The global COVID total today rose to 37,984,579 cases, and 1,083,216 people have died from their infections, according to the Johns Hopkins online dashboard.

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