Relapses among COVID-19 survivors confound researchers
Virus may live in body for weeks
TOKYO — It had been more than a month since Mirabai Nicholson-McKellar was infected with the coronavirus, and the 35-year-old filmmaker thought she was on her way to recovery. Then the shortness of breath came back, followed by chest pains.
A visit to the emergency room and a second test for COVID-19 gave another positive result. Just three days earlier, she’d been cleared by health authorities in Australia’s New South Wales state and was allowed to end her home quarantine after going 72 hours without symptoms.
Her experience adds to a growing number of reports of patients appearing to have a reactivation of symptoms, testing positive again, or even potentially being reinfected. Such incidents don’t align with the generally accepted understanding of how virus infections work and spread.
This so-called false-dawn phenomenon is puzzling health experts as they try to come to grips with the mysterious pathogen. Solving the puzzle will inform a broad range of challenges, from the development of an effective vaccine to how soon governments may be able to allow normal life to resume.
So far, there hasn’t been enough research to conclude why symptoms seem to reemerge in some people, and whether they experience reinfection or if the virus persists for weeks. One possibility is that COVID-19 causes blood clots that may cause potentially dangerous complications unless treated with anticoagulant medications, said Edwin J.R. van Beek, chair of clinical radiology at the University of Edinburgh’s Queens Medical Research Institute.
South Korean researchers also offered some clues this week when they reported that so-called nucleic acid tests might be positive based on the detection of dead viral particles that could give the false impression that a patient is still infectious when they’re not.
“Everyone’s trying to figure this out,” said Yvonne Maldonado, an infectious diseases professor at Stanford Medical School. “What happens when people have been sick and infected — are we going to consider them immune and therefore not susceptible at all? Or are they immune and serve as potential points of infection for other people?”
Officials in countries that managed to suppress an initial wave of the pandemic are dreading the possibility that the virus may have a seasonal pattern and could return in the fall.
There can also be a growing psychological cost. Governments may try to isolate survivors for longer in fear that they are still infectious, adding more anxiety to patients already suffering from the uncertainty of when they will be deemed healthy again.
“A lot of patients will suffer mental health issues,” said Michelle Biehl, a critical-care pulmonary doctor at Cleveland Clinic in Ohio. “They’ll have anxiety, depression, PTSD.”