Hong Kong team reports first documented coronavirus reinfection in patient

A Hong Kong man who recovered from the COVID-19 illness caused by the coronavirus was infected again four-and-a-half months later in the first documented instance of human reinfection, researchers at the University of Hong Kong said on Monday.

The findings indicate the disease, which has killed more than 800,000 people worldwide, may continue to spread amongst the global population despite herd immunity, they said.

The 33-year-old man was cleared of COVID-19 and discharged from a hospital in April but tested positive again after returning from Spain via Britain on Aug. 15.

The patient had appeared to be previously healthy, researchers said in the paper, which was accepted by the international medical journal Clinical Infectious Diseases.

He was found to have contracted a different coronavirus strain from the one he had previously contracted and remained asymptomatic for the second infection.

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A new study on COVID-19 immunity has found that people who were asymptomatic or mildly symptomatic had their antibodies diminish within two to three months. Though larger studies are needed, the findings cast doubt on antibody testing and herd immunity.

The finding does not mean taking vaccines will be useless, Dr. Kelvin Kai-Wang To, one of the leading authors of the paper, told Reuters. "Immunity induced by vaccination can be different from those induced by natural infection." 

Researchers will need to wait for the results of vaccine trials to see how well they work, he said.

World Health Organization (WHO) epidemiologist Maria Van Kerkhove said on Monday that there was no need to jump to any conclusions in response to the Hong Kong case.

Broader look needed

"There's been more than 24 million cases reported to date," Van Kerkhove told a news conference in Geneva when asked about the matter. "We need to look at something like this on a population level."

For example, studies tracking larger numbers of cases over time are needed to better understand how strong and how long the neutralizing antibody response to the virus is in people who've recovered. The immune response also involves a type of white blood cells called T cells that are designed to attack a virus the next time they encounter it for longer-lasting protection.

Instances of people discharged from hospitals and testing positive again for COVID-19 infection have been reported in mainland China. However, in those cases it was not clear whether they had contracted the virus again after full recovery—- as happened to the Hong Kong patient  — or still had the virus in their body from the initial infection.

The preliminary number of patients in China who tested positive again once being discharged from hospital was five per cent to 15 per cent, said Wang Guiqiang, an infectious diseases specialist in China's expert group for COVID-19 treatment, during a press briefing in May.

One explanation was that the virus still existed in the lungs of patients but was not detected in samples taken from upper parts of the respiratory tract, he said. Other possible causes were low sensitivity of tests and weak immunity that could lead to persistent positive results, he said.

Jeffrey Barrett, an expert and consultant with the COVID-19 Genome Project at Britain's Wellcome Sanger Institute, said in emailed comments to Reuters that it was very hard to make any strong inference from a single observation.

"Given the number of global infections to date, seeing one case of reinfection is not that surprising even if it is a very rare occurrence," he said.

To's team had stronger evidence of reinfection than some of the previous reports because it uses the genome sequence of the virus to separate the two infections, Barrett said in a comment to Science Media Centre.