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BENGALURU :
More than 4,250 people have recovered from covid-19 since India reported its first case in late January. But the new concern, based on the experience of China and South Korea, is that those who recover and test negative for SARS-Cov-2, the virus that causes covid-19, may then test positive again.
Doctors say India will need to do a quantitative viral scan to check the viral load in each positive case, closely monitor patients during virus shedding or recovery stage, and compel patients to remain in quarantine for two weeks. even after full recovery to prevent this from happening.
“We still don’t know the exact cause as the investigation is still ongoing, but there are three possible reasons why people experience a relapse,” said Dr. Sandeep Budhiraja, Group Medical Director, Max Healthcare, who oversaw the first convalescent plasma therapy in India. a covid-19 patient. One, the patient could get a new infection. Two, the virus is mutating rapidly (there are currently three strains of SARS-Cov-2) and the person could contract another strain for which they have not developed immunity. The third reason Dr. Budhiraja gave, while emphasizing that this is highly unlikely, was the reactivation of the virus. “There is a possibility that the virus will remain in the body, even after the person tests negative and resurfaces,” he said.
Doctors in Wuhan, where SARS-Cov-2 first emerged in December 2019, have observed a number of cases in which patients tested negative for the virus after recovering, but then tested positive again 50 to 70 days. then. So far, there have been no confirmations of recently positive patients infecting others, according to Chinese health officials. China has not released figures on how many patients fall into this category.
In South Korea, more than 180 patients who recovered later tested positive, prompting health authorities to start an investigation. None of these were found to have infected anyone else. The possibility that people will remain positive and therefore potentially infectious is a matter of international concern, as many countries seek to end blockades.
“If two subsequent tests within 24 hours turn out to be negative for a person after treatment, we send them home,” said Dr. Vijay Raju Krupesh, chief surgeon (intensive care) HCG and member of the Covid Advisory Group, Karnataka. The American Society for Microbiology, however, recommends keeping a recovered patient in quarantine for an additional two weeks. “We need to do a quantitative viral analysis to find out the virus burden on the patient to determine why the infection came back,” he said.
There is a possibility that the test is so sensitive that it detects small and potentially harmless levels of the virus, leading to positive results even if the person has recovered. Furthermore, the test could be compromised if the sample is not collected properly.
“We need to carefully monitor the three stages of the disease: pre-symptomatic, asymptomatic, and virus clearance (recovery). Elimination of the virus appears to take time, “said Dr. H Sudarshan Ballal, president of Manipal Health Enterprises.
Close monitoring of the patient is crucial during the virus removal period. “It varies from patient to patient, from fifteen days to 45 days, depending on the underlying diseases,” said Dr. Rajani Bhat, a Delhi-based pulmonologist. “It is a five-month-old virus and we are all studying its infectivity, which is critical to understanding why the person tests positive again. It may be important to perform multiple tests even after recovery to determine the exact status of the virus,” he said. .
In India, the first three cases of Kerala students studying in Wuhan reported in early February that they recovered and did not test positive again. “The strain that caused the 2002-03 SARS outbreak had sustainable immunity for two to three years, and for the virus that causes the common cold, the body can develop immunity for three to four months,” said Dr. Sanjay K Rai, President, Indian Public Health Association. “It depends on the patient.”
Ultimately, it emerges that immunity is key. “Covid-19 does not provide permanent immunity. If someone is re-exposed and the viral load is much more than their immune system can tolerate, relapse is safe,” said Dr. Ramesh Bilimagga, Medical Director, HCG, a chain from cancer hospitals.
Lung and intensive care specialist Dr. Dileep Raman said the virus may not kill as many as in 2020. “In the coming years, the new coronavirus could be a key reason for respiratory disease.”
