150 reinfected are investigated – Andreas was infected twice

In mid-October, researchers announced that the first Swedish case of covid-19 recurrence had been discovered. It was a 53-year-old woman who got infected in both May and August, and was infection-free in between.

To make sure that a person is actually infected twice, you may need to examine the genome of the virus to rule out that it is the same infection that was left.

Right now investigating The Public Health Agency about 150 cases of recurrence in corona.

– We still believe that there is very little knowledge about reinfections, much is based on previous coronavirus that has not been in a pandemic situation, says Karin Tegmark Wisell, chief physician and department head of the Swedish Public Health Agency.

One of those who has fallen ill again is Andreas Longueville, 46. He works as an anesthetist at the St. Göran Hospital in Stockholm, in the anesthesia clinic. One day in March, when covid-19 was relatively new, he began to feel bad.

– One ordinary spring I had not stayed at home, but I thought that now I should do what I should do and that same night I got a fever. It was like the flu, I got a high fever. I moved house and borrowed a friend’s empty house so as not to infect anyone.

Through your work he had to prove himself and it was clear that he had covid-19.

– I regained my strength quite quickly, after 10-12 days. I think I ran to work the first day I came back.

After illness, antibody tests have been done a couple of times, but none have been found. However, he was sure he had some kind of protection against the virus.

In the spring he worked Andreas Longueville, especially in the intensive care unit, with coronary disease. Towards the fall, covid patients began to appear again, although not to the same extent. One day in October, Andreas Longueville woke up with a sore throat.

– I thought: I am not that sick and I have had covid, but still I chose to follow the recommendations. I had an argument with my boss because we had some personnel problems. We decided that I would do a covid test so I don’t have to wait unnecessarily.

While waiting in response, he lost his sense of smell, began to cough, and developed a fever.

– I started thinking about what I would do if it was negative. We have seen several patients in whom we are clinically convinced that it is covid, but that we must take several samples before we get a positive response.

Andreas Longueville got rid of that dilemma: The test showed an ongoing covid-19 infection. He wonders if his covid results this spring may have turned out wrong, but concludes that it was probably the case that he actually had covid-19 even then.

– The big reflection is that this changes the rules of the game for the entire pandemic. Should I jump like this now? I think of my parents, 70 and older, who have been in isolation, breathing the morning air for a few weeks, but then came the increased spread of the infection and then this.

Karin Tegmark Wisell says it’s not unexpected with people getting sick twice.

– You are expected to get reinfected, but you don’t know when most people get it. There are individual factors behind this, including the alertness of the immune system to the second infection. It also seems to depend on how powerful the infection was at the first opportunity.

Something that also appears to affect the risk of getting infected a second time is the magnitude of the exposure: amid widespread spread of infection, the risk of exposure to the virus is high, says Karin Tegmark Wisell.

– What we know is that there are reinfections. And that we can’t count on people who don’t have a normal immune system for protection. We also know that most people develop measurable antibodies. And according to a German study, in the majority of the ten percent who did not develop measurable antibodies, T cells with activity against the virus that causes covid-19 could be measured.

All possible cases Recurrence can be obtained from the database where diagnosed cases of notifiable diseases are registered. These searches are currently conducted several times a month, but Karin Tegmark Wisell says they are considering adding an alarm for every time such a case appears. Currently about 150 cases of possible relapse are being investigated.

– We have noticed that in many cases people have very low virus levels and then it is not possible to examine the virus genome in the samples. It may be a new infection or the remnants of an old one, but it becomes less interesting to investigate because low virus levels mean that the person is, in all likelihood, less contagious. In other cases, it is not possible to investigate cases where samples are not always stored in laboratories.

Andreas Longueville says that a week after getting sick for the second time, his wife developed symptoms, which later turned out to be covid-19. You can’t be sure you infected it, but think that even those who have been confirmed infected with the virus should be careful.

– I am not pure, but I am healthy and quite fit, but I got quite sick. I don’t feel like I got sick less the second time. You have to continue to be careful.

In addition to testing samples from people who have become ill, periodic samples are taken from all regions in a monitoring program to look for major changes in the virus genome. However, none have been found, says Karin Tegmark Wisell.

– The virus is constantly changing, but what we are looking for are major changes, for example the variant of the mink in Denmark.

Last week came a case of a patient who became ill again at the infection clinic at the Skåne University Hospital in Malmö, where the chief physician and associate professor Johan Tham works.

– It’s a 39-year-old woman in Malmö who, when you yell the covid response, she says – “oh no, not again,” she says.

His test result, which was very positive, indicating high levels of the virus, is now being tested to find out if the virus has changed in appearance.

The 53-year-old woman As DN reported in August, he is said to have had mild symptoms the second time he got sick, so researchers believe he had some immunity left. However, the Malmö woman contracted a notable clinical infection the second time she was infected.

– This time it is evident that he has become ill again, with fever, shortness of breath, the ant crawls through the body and has lost his sense of smell, says Johan Tham.

The patient had already tested the antibodies before reappearance, but none could be seen.

Johan Tham says that he he himself has been ill and has antibodies and describes it as later letting his guard down and thinking he is protected. He still believes that the antibodies have an effect on the virus and make it milder, but he doesn’t think that a lack of antibodies is the only explanation for people getting re-infected.

– It could also have to do with the change in appearance of the virus.

He hopes that the health service will develop a strategy to map the cases of reinfected people.

– It is very important that we know if the virus has mutated and can make people sick again.

Karin Tegmark Wisell says that the vast majority in all probability have protection against a second serious infection, but that there are no guarantees.

– All previous knowledge suggests that the second chance will be smoother than the first, but there will always be those who deviate from the usual.

He also says that the Swedish Public Health Agency will soon issue clearer advice on who should get tested for the virus. As testing capacity is exhausted, the focus will turn to providing adequate care to those in need and reducing the spread of infection.

– It won’t be a priority to get tested again if you get sick with mild symptoms and have already been sick once, says Karin Tegmark Wisell.

Read more: Adam, 42, was on a respirator for nine days