Retrospective Cohort Study Sponsored by Capital Medical University in China Reveals COVID-19 Patients at Risk for Reactivation of Coronavirus

Retrospective Cohort Study Sponsored by Capital Medical University in China Reveals COVID-19 Patients at Risk for Reactivation of Coronavirus

Chinese researchers from the Capital Medical University and Peking University investigated the elements and forces involved with the reactivation of SARS-CoV-2, the virus behind COVID-19 recently. The data could be considered concerning: those people who had COVID-19 and were diagnosed with a lower lymphocyte count or experienced two or less symptoms during their COVID-19 illness are unfortunately facing a higher risk of reinfection. Published in the Journal of Infection and Public Health, the study highlights the unfortunate reality that it’s possible to get reinfected by the coronavirus just days after recovering from the pathogen. In this observational study, the investigators studied 109 patients admitted in a Chinese hospital, considering when these patients were reinfected with COVID-19. They estimated that based on standardized COVID-19 testing for purposes of this study that the frequency of infection reactivation typically occurs at least two weeks (14 days) after recovery or hospital discharge. The team studied test results of the recovered COVID-19 patients comparing the group that was tested positive with recurrent COVID-19 infection with those that were negative to identify the forces and elements behind the reactivation and relapse of the coronavirus.  A thorough data analysis revealed that those individuals with COVID-19 with less than 1500/μl lymphocyte level and two or less symptoms during their first COVID-19-triggered illness face far higher risk for developing a COVID-19 reinfection. Consequentlythis patient population should be monitored more carefully for COVID-19 reactivation. 

The Study was led by corresponding author Calvin Q. Pan with the Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University in Beijing, China. The study was funded by the National Key Research and Development Program and Research Project Grant of Beijing Ditan Hospital. The study team concluded that those that fall in the at risk category have a 27% incidence of COVID-19 reactivation in a cohort of patients with confirmed COVID-19 during a medium follow-up period of 29 days. The key indicators include a lymphocyte count under 1500 cells/ μL and reportedly two or fewer symptoms at the onset of their COVID-19 illness. These factors actually independently predict COVID-19 reactivation among convalescent patients.

Recommendations

In China, where state authorities have more overarching power over the population than, say in Western nations, the researchers suggested that those patients that fall in this category and that struggle to practice appropriate social distancing should in fact “undergo active surveillance to detect disease reactivation.”

The investigators propose another study investigating the viral load during the first illness associated with COVID-19 and disease reactivation. 

The study team suggests that therapeutics must be introduced that can serve as intervention for prophylaxis against reactivation.

The Study Center

A public academic university established in 1960, over 20,000 are employed here along with 26,000 students. Affiliated with 14 hospitals in China, this academic medical center was formerly called Beijing Second Medical College. The university consists of 10 schools and 1 teaching institution. Beijing Ditan Hospital is affiliated with Capital Medical University.

Lead Research/Investigator

Calvin Q. Pan with the Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University in Beijing, China

Responses

  1. Did these people get low lymphocyte levels from having a milder form of Covid-19, or did they have lower levels before getting it? Plenty of fairly common things cause low levels: malaria, TB, HIV, Hepatitis, anemia, and malnutrition from lack of protein. Zinc deficiency.

    The “two symptoms” aspect is interesting and a bit confusing, as this illness seems to have so many symptoms. ( I have a suspicion that people who get good levels of zinc are never going to have that “loss of taste or smell” that is the very first question your doctor asks. ) Unless your one or two symptoms were abrupt and quite strong, how would anyone even suspect they had to Covid? Or is it, these days, that every and any symptom could be the ‘rona, so run to get tested? Or this being from China, the Army is on every street corner with nasal swabs, testing everyone?