Imagine contracting COVID-19 and recovering after a few weeks only to have your symptoms return months later. It sounds like a sick joke, doesn’t it? Unfortunately, this was the reality for a woman in Colorado, USA.
According to Michelle Hart, she first tested positive for SARS-CoV-2 at the end of April after experiencing neurological symptoms. In an interview with CNN, Michelle recalls that she was diagnosed with Guillain-Barré syndrome (GBS) after experiencing muscular weakness, paresthesia, migraines, and neuralgia.
There have been multiple reports of people testing positive for COVID-19 and developing GBS after exposure. Studies state that GBS could be a complication of a COVID-19 infection. Infection with COVID-19 can cause the production of inflammatory cytokines in the body and create an immune-mediated process such as GBS. While there’s no evidence of direct invasion of nerves or nerve roots by the virus, it is believed that there is a causal relationship between GBS and SARS-CoV-2 infection.
After a few weeks, however, Michelle tested negative not once, but twice for SARS-CoV-2 and was given an all-clear by her doctors despite the fact that she was still experiencing a few of the symptoms. Doctors reassured her that while the symptoms may remain for until a month it does not mean she is still infected.
However, in early June Michelle started experiencing severe gastrointestinal symptoms including loss of appetite, nausea, and vomiting which prompted her to return to the hospital and get tested. Whereupon it was revealed that she was positive for SARS-CoV-2 a second time around.
While an alarming situation this is certainly not the first time a person has tested positive twice for coronavirus. Multiple reports have come out from South Korea and Japan of people testing positive for coronavirus after initially recovering from the infection.
Doctors theorize that this might be due to a reactivation of the virus rather than reinfection. It is believed that the virus may lie dormant in some individuals like the varicella virus that can integrate into the host’s DNA and lie dormant in nerve root ganglion. The virus can later get reactivated due to stress or periods of low immunity. However, others argue that coronaviruses such as SARS-CoV-2 don’t integrate into our DNA and nor do they have a dormant phase.
It is important to note however that Michelle never developed antibodies against the virus during her first exposure to COVID-19. Doctors believe this could be one of the reasons for her reinfection. While presence of antibodies is generally believed to protect one from reinfection, studies show that antibodies against SARS-CoV-2 only last for a short period of two to three months.
The bottom line remains that the lack of evidence against the novel coronavirus means extensive research is required before doctors can accurately predict the virus’s behavior.
References:
Farzi MA, Ayromlou H, Jahanbakhsh N, Bavil PH, Janzadeh A, Shayan FK. Guillain-Barré syndrome in a patient infected with SARS-CoV-2, a case report [published online ahead of print, 2020 Jun 20]. J Neuroimmunol. 2020;346:577294. doi:10.1016/j.jneuroim.2020.577294
Long, Q., Tang, X., Shi, Q. et al. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections. Nat Med(2020). https://doi.org/10.1038/s41591-020-0965-6
