COVID-19 and Postinfection Immunity

Kirkcaldy, Robert D.; King, Brian A.; Brooks, John T.

doi:10.1001/jama.2020.7869

Cited by 219 publications

(103 citation statements)

References 11 publications

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“…A case of COVID-19 recurrence in a 48-year-old man was recently published [8]. As in the present case, the patient had anti-SARS-CoV-2 IgG, indicating that the acute phase of the disease and immunological reaction occurred, and suggesting that in some cases the presence of IgG antibodies could be not protective [8], although these suggestions should be taken with caution [9].…”

Section: Case Presentationmentioning

confidence: 44%

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Possible COVID-19 recurrence in an older patient: a case report

Garnier‐Crussard

Haution

Gueret-Du-Manoir

et al. 2020

Preprint

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Background: Novel coronavirus (COVID-19) pandemic cause by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) threatens the world for few months. Few cases of prolonged positivity of viral tests and clinical recurrence of COVID-19 have been described. We report the case of a 78-year-old woman with metastatic breast cancer who developed possible COVID-19 recurrence in a post-acute and rehabilitation unit. Case presentation: A 78-year-old woman with metastatic breast cancer and hypertension developed COVID-19. After symptom improvement and RT-PCR negativation, she regained symptom (fever, fall) and lymphopenia on Day 26 and we note a turned positive RT-PCR even though she was tested positive for antibody against SARS-CoV-2. After the diagnosis of possible COVID-19 recurrence, she was transferred back to an acute “COVID-19” unit and she then quickly clinically recovered. Conclusions: This clinical case allows us to discuss the risk of recurrence and possible specific causes in older patients. Moreover, prolonged symptoms and lymphopenia could be associated to worse outcomes in older patients. Finally, at a collective level, even if traces of virus detected by RT-PCR were not necessarily correlated with the contagiousness, the importance of possible COVID-19 recurrence in the care pathway for older adults must be taken into account, since they are often surrounded by frail older people.

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Section: Case Presentationmentioning

confidence: 44%

“…At the same time, a control chest computed tomography showed improvement in bilateral patchy ground glass opacities ( Figure). [4][5][6]9]. Increasing age, male gender, hypertension and corticosteroid treatment, which we know are highly prevalent in older adults, were recently associated to delay in viral clearance [10].…”

Section: Case Presentationmentioning

confidence: 99%

Possible COVID-19 recurrence in an older patient: a case report

Garnier‐Crussard

Haution

Gueret-Du-Manoir

et al. 2020

Preprint

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“…Recovered individuals remained immune, in the absence of clear evidence about duration of protection. [41] For the base model reflecting the status quo situation of response efforts to date in Liberia, quarantine and isolation were undertaken by some of the individuals identified through contact tracing. The impact of contact tracing on transmission was modeled by having a subset of new infections immediately removed from the infectious population; that is, a percentage ( ) of presymptomatic individuals would undertake quarantine and remain isolated through recovery or death, either at home or in a hospital depending on severity of symptoms, due to contact tracing.…”

Section: Methodsmentioning

confidence: 99%

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

Skrip

Fallah

Bedson

et al. 2020

Preprint

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Background: Long-term suppression of SARS-CoV-2 transmission will require context-specific strategies that recognize the heterogeneous capacity of communities to undertake public health recommendations, particularly due to limited access to food, sanitation facilities, and physical space required for self-quarantine or isolation. We highlight the epidemiological impact of barriers to adoption of public health recommendations by urban slum populations in low- and middle-income countries (LMICs) and the potential role of community-based initiatives to coordinate efforts that support cases and high-risk contacts. Methods: Daily case updates published by the National Public Health Institute of Liberia were used to inform a stratified stochastic compartmental model representing transmission of SARS-CoV-2 in two subpopulations (urban poor versus less socioeconomically vulnerable) of Montserrado County, Liberia. Differential transmission was considered at levels of the subpopulation, household versus community, and events (i.e., funerals). Adoption of home-isolation behavior was assumed to be related to the proportion of each subpopulation residing in housing units with multiple rooms, access to sanitation facilities, and access to basic goods like water and food. Percentage reductions in cumulative infection counts, cumulative counts of severe cases, and maximum daily infection counts for each subpopulation were evaluated across intervention scenarios that included symptom-triggered, community-driven efforts to support high-risk contacts and confirmed cases in self-isolation following the scheduled lifting of the state of emergency. Results: Modeled outbreaks for the status quo scenario differed between the two subpopulations, with increased overall infection burden but decreased numbers of severe cases in the urban poor subpopulation relative to the less socioeconomically vulnerable population after 180 days post-introduction into Liberia. With more proactive self-isolation by mildly symptomatic individuals after lifting of the public health emergency, median reductions in cumulative infections, severe cases, and maximum daily incidence were 7.6% (IQR: 2.2%-20.9%), 7.0% (2.0%-18.5%), and 9.9% (2.5%-31.4%) for cumulative infections, severe cases, and maximum daily incidence, respectively, across epidemiological curve simulations in the urban poor subpopulation and 16.8% (5.5%-29.3%), 15.0% (5.0%-26.4%), and 28.1% (IQR: 9.3%-47.8%) in the less socioeconomically vulnerable population. An increase in the maximum attainable percentage of behavior adoption by the urban slum subpopulation, with the provision of support to facilitate self-isolation or quarantine, was associated with median reductions in cumulative infections, severe cases, and maximum daily incidence were 19.2% (IQR: 10.1%-34.0%), 21.1% (IQR: 13.3%-34.2%), and 26.0% (IQR: 11.5%-48.9%), respectively, relative to the status quo scenario. Conclusions: Broadly supported post-lockdown recommendations that prioritize proactively monitoring symptoms, seeking testing and isolating at home by confirmed cases are limited by resource constraints in urban poor communities. Investing in community-based initiatives that determine needs and coordinate needs-based support for self-identified cases and their contacts could provide a more effective, longer-term strategy for suppressing transmission of COVID-19 in settings with prevalent distrust and socioeconomic vulnerabilities.

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“…Short immunity periods are the case for seasonal human coronaviruses (Callow et al, 1990;Galanti and Shaman, 2020;Kissler et al, 2020). Although natural infection with SARS-CoV-2 can induce neutralizing antibodies in humans (Brouwer et al, 2020;Chi et al, 2020;Ju et al, 2020;Shi R. et al, 2020), we still do not know if the infection confers immunity to prevent reinfection and, if so, for what duration (Altmann and Boyton, 2020;Ibarrondo et al, 2020;Isho et al, 2020;Kirkcaldy et al, 2020;Long et al, 2020;Robbiani et al, 2020;Staines et al, 2020). Many cases that tested positive after once turning negative are currently considered as reactivation, long-term shedding, or detection of residual genetic material Mahase, 2020b;Xiao A. T. et al, 2020) although a few cases of possible reinfection have been reported (Bloomberg, 2020).…”

Section: Coronaviruses Including Sars-cov-2mentioning

confidence: 99%

Viruses That Can and Cannot Coexist With Humans and the Future of SARS-CoV-2

Furuse

Oshitani

2020

Front. Microbiol.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a worldwide pandemic. Many projections concerning the outbreak, such as the estimated number of cases and deaths in upcoming months, have been made available. However, what happens to the virus after the pandemic subsides has not been fully explored. In this article, we discuss the ways that past and present human viruses have emerged via zoonotic transmission, the mechanisms that they have acquired the ability for effective transmission among humans, the process to sustain a chain of transmission to coexist with humans, and the factors important for complete containment leading to eradication of viruses. These aspects of viral disease may provide clues for the future path that SARS-CoV-2 might take in relation to human infection.

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COVID-19 and Postinfection Immunity

Abstract: This Viewpoint describes what is currently known about the immune response to coronavirus disease 2019 (COVID-19), highlights important gaps in knowledge, and identifies opportunities for future research.

Cited by 219 publications

References 11 publications

Possible COVID-19 recurrence in an older patient: a case report

Possible COVID-19 recurrence in an older patient: a case report

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

Viruses That Can and Cannot Coexist With Humans and the Future of SARS-CoV-2

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