Hyderabad: Genomic scientists from the Council of Scientist and Industrial Research (CSIR), through genetic sequencing, have reported the first instance of two Covid-19 reinfections in India. This is perhaps for the first time in the country that geneticists have reported Covid reinfections backed by genome sequencing studies of SARS-CoV-2 virus.

Published in the Oxford University Press for the Infectious Diseases Society of America on Wednesday, the study said that two healthcare workers, a 25-year-old-male and another 28-year-old female, who were posted in a Covid-19 unit of a tertiary health care facility in North India, were re-infected by genetically distinct SARS-CoV-2.

The two healthcare workers first tested positive through RT-PCR test on May 5 and May 17 respectively. After hospitalisation, subsequently they tested negative for SARS-CoV-2 through RT-PCR on May 13 and May 18.

After recovering, both the healthcare workers resumed their duties in the hospital but the two individuals tested positive again through RT-PCR tests for SARS-CoV-2 on August 21 and September 5, 2020 respectively.

Interestingly, the healthcare workers were asymptomatic both the times but had a higher viral load on the second episode of the reinfection. “This is the first instance of Covid-19 reinfection from India of two asymptomatic healthcare workers identified on routine surveillance. Genome sequencing of the SARS-CoV-2 isolated from both the episodes suggest a distinctly different virus, confirming reinfection,” said genome scientist, Vinod Scaria from CSIR-Institute of Genomics and Integrative Biology (IGIB), who led the study.

The CSIR-IGIB study on reinfection also raises a lot of questions on response from public health officials towards handling asymptomatic Covid-19 reinfections. There is a possibility that individuals who are asymptomatic and getting re-infected are underreported.

“Since the two individuals were asymptomatic and identified on regular surveillance, it suggests that asymptomatic reinfections could be an under-reported entity. Since healthcare workers have higher risk of exposure, regular surveillance could potentially uncover the real incidence,” Scaria said.

Referring to the ground-breaking CSIR reinfection study, Professor Akiko Iwasaki from Yale School of Medicine, said “the study shows two cases of reinfection by SARS-CoV-2. Both were asymptomatic after the first and second infection. Curiously, the reinfection in both the cases led to much higher viral load than the first infection. These results emphasise the need for more surveillance”.

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