- Researchers reported an unusual case study in which an older unvaccinated woman died after developing two strains of SARS-CoV-2
- As the delta variant spreads in the U.S. and more people return to a familiar life, the chance of contracting two strains increases if a person is unvaccinated and in a crowded setting.
- COVID-19 vaccines are highly effective against all variants, and most people hospitalized from COVID-19 right now are not vaccinated.
After the case study of an unvaccinated older woman found to have acquired both the alpha and beta variants of COVID-19 was presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2021), experts confirmed it is possible to have two variants of COVID-19.
On March 3, a woman was admitted to a hospital in Belgium for treatment of injuries from a fall. Following a procedural test, she was found to be positive for the virus, according to a press release from ECCMID.
At the time, she showed no symptoms of COVID-19 but rapidly developed respiratory problems and died 5 days later.
When her respiratory sample was tested for variants of concern (VOCs) using the PCR test, doctors discovered she had two different strains of COVID-19, the B.1.1.7 (alpha) originating in the United Kingdom, and B.1.351 (beta), first detected in South Africa.
“This is one of the first documented cases of coinfection with two SARS-CoV-2 variants of concern,” lead author and molecular biologist Dr. Anne Vankeerberghen of the OLV Hospital in Aalst, Belgium, said in the statement.
“Both these variants were circulating in Belgium at the time,” Vankeerberghen continued. “So it is likely that the lady was coinfected with different viruses from two different people. Unfortunately, we don’t know how she became infected.”
Not the first time dual infection identified
Similar cases of dual infection have been detected, although experts believe the Belgian case is the first documented, so far.
Scientists in Brazil reported two patients had two COVID-19 variants at the beginning of the year — one of them the VOC called gamma.
A teenager was recently treated by researchers in Portugal and appeared to have a second type of COVID-19 while recovering from a preexisting COVID infection.
“The early-on dynamic coinfection may have contributed to the severity of COVID-19 in this otherwise healthy young patient, and to her prolonged SARS-CoV-2 shedding profile,” the researchers wrote.
Vaccination key to problem of dual infection
Dr. Nikhil Bhayani, an infectious diseases specialist at Texas Health Resources, spoke with Healthline about what this means for the United States.
“We are learning something new about these strains every day,” said Bhayani. “Per the CDC, the delta variant is the predominant strain in the U.S.” It now accounts for over 50 percent of new cases.
He explained that as new variants arise, the virus could become more transmissible and increase the chances of making this condition severe.
Asked if infection with multiple strains could become an issue in unvaccinated people during the next flu season, with a return to masking and social distancing this fall, he emphasized the importance of getting vaccinated.
“Only time will tell,” said Bhayani. “If more people go out and get vaccinated, we might not need to resort to masking and social distancing. It is a trade-off.”
He noted that the current vaccines can protect against the variants so far identified.
“Yes, but keep in mind there can be ‘breakthrough’ infection with vaccinations,” he cautioned. “However, there is a good chance severity of illness would be mitigated.”
Whether the mRNA or adenovirus vector vaccines have any advantage against dual infection, Bhayani said, “more data would be needed” to determine if one had any advantage over the other.
He also confirmed, “All three vaccines available in the U.S. have shown to be effective against the delta variant.”
Could we be missing variants?
Dr. Natalia Gutierrez, family medicine, at Texas Health Resources, noted that in the United States, we are not testing for variants from all coronavirus samples.
“The fact that they typed it and they know what type of variant it is, it’s surprising,” said Gutierrez. “Because they’re testing it, and in the U.S. we’re not testing all the samples to see what variants we’re getting.”
As the country reopens and experiences a surge in the delta variant, acquiring more than one variant is a risk when crowds gather, Gutierrez said.
“Yes, absolutely — we see this where influenza is a good example,” she said. “I have patients that have flu A and then later have flu B. So yes, you can have the [virus] mix in crowds if you have multiple people that have different variants.”
People in areas with low vaccination rates at higher risk
According to Gutierrez, areas with low vaccination rates are still susceptible to a surge in cases.
“If we have very low vaccine uptake, that’s not going to help us,” she said. Gutierrez also believes pandemic efforts are being held back by politics.
“Unfortunately, COVID has become a political issue, and I think if all the decisions we made were based on science,” she said. “I think that there would probably be masks again and shut down again. But the decisions are not being made based on science, but more politics.”
She noted that many people are hesitant to get vaccinated, for very different reasons, and those states with low vaccine uptake are getting hit harder with the pandemic.
“It’s good evidence that without a massive amount of people getting vaccinated, we’re likely not going to be where we need to be,” Gutierrez cautioned.
“COVID has shown to be relentless. Every time we think we’re doing better a new mutation comes up. Also, we have the problems of a global pandemic,” she said. “So unless we tackle this as a global effort, I think it’s going to take some time for us to improve.”
The bottom line
A recent study finds that acquiring two COVID-19 strains is possible.
Researchers do not know how the patient acquired the variants, but exposure to people carrying different COVID-19 strains can result in this type of case.
Experts also say that low immunization rates mean cases will likely continue to increase in the U.S. and that without a “massive” number of people getting the vaccine, it will be a long time before the situation improves.
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