Coronavirus, the mystery of repeat offenders: bis infection can lead to death

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Does the coronavirus, like the postman, always knock twice? Fortunately, no, or at least for now, it is not proven. Yet sometimes there have been cases of (apparent) reinfection in patients judged to have recovered, because they were negative for the two swabs of practice, but then again tested positive for Covid-19. The last in order of time is the case of the 76 year old lady from Pago Veiano, in Sannio, who died two days ago at the Rummo hospital in Benevento, because she returned positive to the coronavirus, after instead, a few days earlier, she had been declared cured and negative, to the two swabs of practice. A case that is certainly exceptional, but not unique, given that on 19 April we documented another very similar case in Campania, in Mugnano, where a 55-year-old girl did not survive the recovery of the infection after a negative swab. Almost analogous situations, but we emphasize very rare, have also been detected abroad as in South Korea, China and Japan. «First of all, it must be said that, although extraordinarily reliable, swabs like all tests do not have 100% reliability, therefore there could be cases of false negatives – underlines the professor Roberto Cauda, ordinary of infectious diseases of the Catholic Campus of Rome – In these cases of apparent contagion-bis, speaking in general and without knowing the clinical data of the patients, rather than reinfections, so far not yet demonstrated in international studies, it could be a replication of the lung virus that had slowed down, but not ended, and then restarted due to the patient’s individual condition. The real message of these situations is how sneaky this virus is and how much this disease should always be considered with great attention, because we don’t yet know enough about it, “concludes the infectious disease specialist.

Now we know from the results published on April 29, by the prestigious scientific journal Nature Medicine, that those who fall ill develop an immune response to the virus within 19 days of the onset of symptoms and develop immunity that remains in the body and therefore no longer makes them sick. «This disease remains mysterious in many ways, even if we know it better and better. We know that there are people who have recovered or asymptomatic positive for Covid even over 70 days, as well as, exceptionally, there are patients who, after being negative on the test, have a repositivization of the pharyngeal swab, because probably the viral load had become insufficient to be detected and then instead the virus regained its strength “, confirms the scientific director of the Italian Society of Infectious and Tropical Diseases, Massimo Andreoni. But why does the virus hibernate in some patients and then revive? “There is no single reason, perhaps because the immune defenses are a bit out of date and the virus that remains in the body then makes it to replicate itself again or there are triggering factors such as other infections or other pathological conditions that reactivate the virus. If the replication and therefore the infection reactivates it can be very heavy for the patient who is still recovering and weak from the first manifestation of the disease, “explains Andreoni. In short, a negative result does not say definitively that that person is by no means the most carrier of the virus, but that the quantity of genetic material detectable by the swab is scarce. “But it is forbidden to make alarms: when we say that a person is negative – he warns – we know that a very low amount of the virus is still present, but at such a mild level that it is not detected and, let’s be clear, it cannot even be infected because it is too weak. Cases of disease recovery after a negative swab are exceptionally rare. ”

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