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Can you be infected by two coronaviruses at once?

Can you be infected by two coronaviruses at once?


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E.g. could you be infected by COVID-19 as well as a different strand of coronaviruses (e.g. those that circulate in the population every flu season)?


Yes:

Coinfections involving multiple HCoVs were also detected (Table 2).

  • Human Coronaviruses HCoV-NL63 and HCoV-HKU1 in Hospitalized Children with Acute Respiratory Infections in Beijing, China, Advances in Virology (2011)

Patients could catch TWO Covid strains at once – as docs warn of ‘more dangerous dual infection’

PATIENTS could catch two Covid strains at once, scientists say, after reports of dual infection from Brazil.

And it could lead to even more new variants evolving, with abilities to dodge vaccines and spread easier.

Amid growing concern of new variants popping up globally, doctors said they were the first to describe the phenomenon of a coronavirus coinfection.

Two people in their 30s tested positive for two Brazilian strains known as P.1 and P.2.

The patients were infected in late November with the P.2 variant of coronavirus identified in Rio.

They simultaneously tested positive for the P.1 variant of the virus which evolved separately in Manaus, which was confirmed with laboratory tests.

The patients’ symptoms were reportedly mild, with a dry cough in one case, and coughing, sore throat and headache in the second. They did not need hospital care.

Dr Fernando Spilki, a virologist at Feevale University in Rio Grande do Sul state and lead researchers, said dual infection was only likely to happen when different viruses are circulating in high numbers.

Since November, Brazil has been fighting a steep second wave of infections, routinely recording over 1,000 deaths per day in 2021.

Hospitals are at capacity in the country amid a resurgence of cases caused by new strains of the virus.

The case studies reported by Dr Spilki and colleagues raise concerns among scientists that coinfection could speed up the development of new mutations, and therefore new variants of the coronavirus.

“These co-infections can generate combinations and generate new variants even more quickly than has been happening,” Dr Spilki said, according to Reuters.

“It would be another evolutionary pathway for the virus."

One of the ways mutations evolve is by coinfection of the same cell.

This is thought to be one way the new UK strain of coronavirus picked up a more worrisome mutation characteristic of the South African and Brazil variants.

But scientists admitted this was a “rare” way for coronaviruses to gain mutations.

Speaking on the back of the research - which has not been peer-reviewed - scientists said it was already the case that people get infected with two strains of a virus at once.

“It is perfectly possible for a child attending a primary school to get infected with one variant of Covid-19, and an older sibling to attend secondary school and get infected with a different Covid-19 variant - and for both children to bring their viruses home to infect each other - and their parents with both variants,” Dr Julian Tang, a professor in respiratory sciences at the University of Leicester, told MailOnline.

Professor Keith Neal, an infectious diseases expert at the University of Nottingham, said if there's a lot of transmission “you can pick up two different viruses around the same time”.

But when one strain is predominant, that is unlikely.

In the UK, the Kent variant has quickly become the most prevalent strain, however, there are others still in circulation.

It comes as ministers race to avoid another new variant from South Africa wreaking havoc, after more than 100 cases have been identified in the UK since December, at least 11 of them with no travel links to South Africa.

The Health Secretary Matt Hancock has vowed to “come down hard” on the variant with the introduction of a mass testing scheme.

A door-to-door testing blitz on up to 350,000 people was launched this week in areas where the South African strain is feared to be transmitting within the community.

Meanwhile, the UK's Kent Covid strain has acquired a mutation similar to the South African variant, and could resist jabs, official reports revealed.

A cluster of 32 cases in Liverpool also have the same mutation but relate to the original strain of coronavirus that has been around since the start of the pandemic, from Wuhan.

Mr Hancock said yesterday the new variants pose "renewed challenges" as the UK makes great strides in its vaccination rollout.

Dr Tang said the mutation was a “worrying development, though not entirely unexpected”.

Regarding the E484K mutation seen in the Kent variant, Dr Jonathan Stoye, from the Francis Crick Institute, said the PHE report suggests the UK variant is now independently acquiring the E484K change.

“From a virological standpoint, appearance of new variants by mutation during replication cannot be considered surprising,” he added.

“Whether this change will provide significant growth advantages for the novel virus causing it to predominate remains to be seen.”

New variants threaten resistance to vaccines, and could also increase the risk of reinfection in people who have previously recovered from Covid.


Related News

The detection of multiple variants in a person could be the result of co-infection by the different variants, or the generation of mutations within the patient after the initial infection. One way to discriminate these two scenarios is by comparing the sequences of the variants circulating in the population with those in the patient. In the Brazilian study mentioned above, the variants identified corresponded to different lineages that had been previously detected in the population, implying co-infection by the two variants.


Study Reveals New Clues about Biology of COVID-19

A new study published in the journal Cell pinpoints the likely cell types SARS-CoV-2, a new coronavirus behind the COVID-19 disease, infects it also shows that one of the human body’s main defenses against viral infections may actually help SARS-CoV-2 infect those very cells.

Colorized scanning electron micrograph of an apoptotic cell (red) infected with SARS-COV-2 virus particles (yellow), isolated from a patient sample. Image credit: NIAID.

“We started to look at cells from tissues such as the lining of the nasal cavity, the lungs, and gut, based on reported symptoms and where the SARS-CoV-2 virus has been detected,” said study lead author Dr. Jose Ordovas-Montanes, of Boston Children’s Hospital.

“We wanted to provide the best information possible across our entire spectrum of research models.”

Like the closely related SARS-CoV-1 virus that caused the SARS pandemic, SARS-CoV-2 uses a receptor called ACE2 to gain entry into human cells, aided by an enzyme called TMPRSS2.

That led Dr. Ordovas-Montanes and colleagues to ask a simple question: which cells in respiratory and intestinal tissue express both ACE2 and TMPRSS2?

To address this question, the researchers turned to single-cell RNA sequencing, which identifies which of roughly 20,000 genes are ‘on’ in individual cells.

They found that only a tiny percentage of human respiratory and intestinal cells, often well below 10%, make both ACE2 and TMPRSS2.

Those cells fall in three types: goblet cells in the nose that secrete mucus lung cells known as type II pneumocytes that help maintain the alveoli (the sacs where oxygen is taken in) and one type of so-called enterocytes that line the small intestine and are involved in nutrient absorption.

Sampling from non-human primates showed a similar pattern of susceptible cells.

“Many existing respiratory cell lines may not contain the full mix of cell types, and may miss the types that are relevant,” Dr. Ordovas-Montanes said.

“Once you understand which cells are infected, you can start to ask, ‘How do these cells work?’ ‘Is there anything within these cells that is critical for the virus’ life cycle?’”

“With more refined cellular models, we can perform better screens to find what existing drugs target that biology, providing a stepping stone to go into mice or non-human primates.”

But it was the study’s second finding that most intrigues the authors.

They discovered that the ACE2 gene is stimulated by interferon — one of the body’s main defenses when it detects a virus.

Interferon actually turned the ACE2 gene on at higher levels, potentially giving the virus new portals to get in.

“ACE2 is also critical in protecting people during various types of lung injury,” Dr. Ordovas-Montanes said.

“When ACE2 comes up, that’s usually a productive response. But since the virus uses ACE2 as a target, we speculate that it might be exploiting that normal protective response.”

Interferons, in fact, are being tested as a treatment for COVID-19. Would they help, or would they do more harm than good? That’s not yet clear.

“It might be that in some patients, because of the timing or the dose, interferon can contain the virus, while in others, interferon promotes more infection,” Dr. Ordovas-Montanes said.

“We want to better understand where the balance lies, and how we can maintain a productive antiviral response without producing more target cells for the virus to infect.”

The findings may also raise new lines of inquiry around ACE inhibitors.

These drugs are commonly used to treat hypertension, which has been linked to more severe COVID-19 disease. Are ACE inhibitors affecting people’s risk?

“ACE and ACE2 work in the same pathway, but they actually have different biochemical properties,” Dr. Ordovas-Montanes said.

“It’s complex biology, but it will be important to understand the impact of ACE inhibitors on people’s physiological response to the virus.”

It’s also too soon to try to relate the study findings to the cytokine storm, a runaway inflammatory response that has been reported in very sick COVID-19 patients.

“It might be that we’re seeing a cytokine storm because of a failure of interferon to restrict the virus to begin with, so the lungs start calling for more help. That’s exactly what we’re trying to understand right now.”


What research has there been on this subject?

A study on recovered COVID-19 patients in the southern Chinese city of Shenzhen found that 38 out of 262, or almost 15% of the patients, tested positive after they were discharged. They were confirmed via PCR (polymerase chain reaction) tests, currently the gold standard for coronavirus testing. The study has yet to be peer reviewed, but offers some early insight into the potential for re-infection. The 38 patients were mostly young (below the age of 14) and displayed mild symptoms during their period of infection. The patients generally were not symptomatic at the time of their second positive test.

In Wuhan, China, where the pandemic began, researchers looked at a case study of four medical workers who had three consecutive positive PCR tests after having seemingly recovered. Similar to the study in Shenzhen, the patients were asymptomatic and their family members were not infected.


What is an infectious disease and how does it spread?

Diseases spread through host-to-host contact or through vector-to-host contact. Imagine you have the flu, and you sneeze, making a sneeze cloud full of small droplets of liquid, each of which contains the flu virus. If those droplets make their way to the mucus membranes, like the nose or mouth, of another potential host, the disease can spread to them. Some diseases require exchange of bodily fluids (HIV, STIs), while others need direct contact with an individual or object that carries the disease agent (scabies, lice), and others can spread in droplets in the air (flu, cold, SARS coronavirus).

Agencies like the CDC devote many research dollars and personnel to predicting infectious disease spread. They oversee three National Centers for:

  • Emerging and Zoonotic Infectious Diseases (NCEZID) – Zika, etc.
  • HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) – blood-borne and sexually transmitted diseases
  • Immunization and Respiratory Diseases (NCIRD) – influenza, SARS, etc.

At those agencies, biologists who specialize in mathematical modeling use data and math to try to predict how a disease will spread. These predictions help public health agencies determine if they have an epidemic situation of disease spread, how many people will become sick, how fast the disease will spread, and what actions a local community might take to prevent that spread.


Read More

Here is everything you need to know.

Is it possible to contract Covid-19 and flu at the same time?

Yes, it’s entirely possible to contract Covid-19 and flu at the same time.

The news coming out of California confirms this, and although that case is making headlines, it is far from the first.

As far back as March, it was reported that nine patients from Wuhan (the Chinese city where the coronavirus is believed to have originated) tested positive for Covid-19 and influenza viruses.

Of these nine patients, only one had not recovered from Covid-19 by the time The Lancet – which published the findings – had gone to print.

Since then, there have been over 80 published reports of patients infected with both influenza and Covid-19 from around the world.

Are you more likely to die if you have both?

The verdict’s still out on that one.

In many of the studies mentioned above, researchers found that the influenza infection did not make the Covid-19 patients’ medical outcomes any better or worse.

However, in the UK, many scientists – including England’s chief medical officer, Professor Jonathan Van-Tam – believe contracting both the flu and Covid-19 together significantly increases your risk of death.

His conclusions are based on evidence from a study of only 58 people, carried out in the UK during the early stages of the pandemic we’ve learned a lot more about Covid-19 since then.

Prof Van-Tam said the study, although small, tallied with other work that has been done, and said in September: “As I understand it, it’s 42 per cent of those with co-infection died compared with 26.9 per cent of those who tested positive for Covid only.”

He added that these were people who had been hospitalised and had tested positive for both the flu and Covid-19.

Yvonne Doyle, medical director of Public Health England said, “The last thing you really want to have is flu. And if you do think you have either flu or Covid, stay at home and self-isolate. That’s to protect yourself - you’d be feeling very miserable - but also to protect others.

“If you get both, you are in some serious trouble, and the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system, or their risk for serious outcomes. So please protect yourself against the flu this year.”

What are the symptoms of a double infection?

Unfortunately, it's extremely difficult to tell if you have a flu-Covid co-infection.

That's because the symptoms of each are very similar, and once a Covid-19 positive test comes back, doctors rarely seek further tests for other viral infections.


Is it possible to get reinfected with COVID-19?

Yes, but the likelihood of this happening is rare. Current CDC language states that "reinfection with COVID-19 have been reported, but remain rare" overall. Reinfection means you've successfully overcome COVID-19 at some point, fully recovered and have tested negative for an active SARS-CoV-2 infection, before then contracting the virus again at a later date (even if you don't show symptoms). Many experts, including those at the CDC, maintain that confirmed reinfections are very rare &mdash but the issue here may be that care providers have trouble determining when the first infection is over and when a second one begins.

"For almost every doctor who cares for COVID patients, there have been questions raised about whether some of their patients may indeed have had second infections," explains William Schaffner, M.D., the medical director for the National Foundation for Infectious Diseases, adding that most data suggests natural immunity lasts for at least 6 months. "But on occasion, there are people who, even within six months, think they may have been infected twice &mdash they may have, but we just don't have enough scientific information to confirm that a second infection did occur."

What's clear, however, is that anyone who has immunity &mdash whether because they've recovered from COVID-19 directly or have received a vaccine &mdash must continue to practice preventative measures to avoid getting sick twice. Both doctors agree: Immunity and its antibodies produced by an infection doesn't make you invincible, but can aid your body in fighting off smaller, targeted amounts of SARS-CoV-2 should you come across it once more.


What Else Does COVID-19 Do to Your Body?

Some people also have symptoms including:

  • Pinkeye
  • Rashes
  • Liver problems or damage
  • Heart problems
  • Kidney damage
  • Dangerous blood clots, including in their legs, lungs, and arteries. Some clots may cause a stroke.

Researchers are looking into reports of mouth sores and skin rashes, including reddish-purple spots on fingers or toes.

In general, children don't get as sick with coronavirus as adults do, but they can be infected and it can also be deadly for them. Some children and teens have been admitted to the hospital with an inflammatory syndrome that may be linked to the new coronavirus. Symptoms include a fever, rash, belly pain, vomiting, diarrhea, and heart problems. The syndrome, now being referred to as multisystem inflammatory syndrome in children, or MIS-C is similar to toxic shock or to Kawasaki disease, a condition in children that causes inflammation in blood vessels. We’re still learning about these cases.

The long term effects of COVID-19 on your body are still unclear. Some patients have become what is being called "long-haulers" where they suffer symptoms for weeks and even months.

Sources

Raina McIntyre, PhD, NHMRC Principal Research Fellow, Professor of Global Biosecurity, University of New South Wales, Sydney, Australia.

MedlinePlus: “Viral Infections,” “Fever.”

CDC: “Coronavirus Disease 2019 (COVID-19).”

Science: “Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation.”

Genetics Home Reference: “What is a cell?”

Federation of American Scientists: “Do you have COVID-19 questions? Our scientists have answers.”

Journal of the American Medical Association: “Coronavirus infections—more than just the common cold.”

Harvard Health Publishing: “That nagging cough.”

Morbidity and Mortality Weekly Report: “Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) – United States, February 12 – March 16, 2020.”

American Lung Association: “What causes pneumonia?” “Learn about ARDS.”

Cleveland Clinic: “Here’s the Damage Coronavirus (COVID-19) Can Do to Your Lungs.”

Johns Hopkins Medicine: “I’ve been diagnosed with the new coronavirus disease, COVID-19. What should I expect?”

UpToDate: “Coronavirus disease 2019 (COVID-19): Epidemiology, virology, clinical features, diagnosis, and prevention.”

CDC: “Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19).”

Cleveland Clinic: “Here’s the Damage Coronavirus (COVID-19) Can Do To Your Lungs.”

American Academy of Ophthalmology: “Coronavirus Eye Safety.”

The Lancet Gastroenterology and Hepatology: “Liver injury in COVID-19: management and challenges.”

Thrombosis Research: “Incidence of thrombotic complications in critically ill ICU patients with COVID-19.”

Medscape: “Kidney Complications in COVID-19 Send Hospitals Scrambling.”

Consul General of the Official Colleges of Podiatrists, Spain: “COVID-19 Compatible Case Register.”

New York City Health Department: “2020 Health Alert #13: Pediatric Multi-System Inflammatory Syndrome Potentially Associated with COVID-19.”


We're beginning to understand the biology of the covid-19 virus

THE covid-19 virus is humanity’s newest foe, with the potential to prematurely end millions of lives. To control this new coronavirus, we need to understand it. Labs around the world are now working around the clock in a bid to know their enemy.

Three crucial questions are occupying virologists. What makes the new virus so good at infecting people? How does it reproduce so quickly once it is inside us? And why doesn’t the virus cause symptoms straight away, allowing it to &hellip

Article amended on 23 March 2020

We clarified what structures researchers are determining.

Article amended on 24 March 2020

We clarified that disrupting the virus's ability to copy itself can help people infected with covid-19.

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