Coronavirus: Can you contract two COVID-19 variants at the same time?

An older woman from Belgium has been subject to scientific review after it emerged that she died from contracting two strains of the SARS-COV-2 virus.

More recently, scientists from Brazil have also reported two particular case studies wherein two people who had tested positive for coronavirus, had been genomically found to have two strains of the virus at the same time.

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While we do know that the new emerging strains of coronavirus have an impact on the severity and some people are more at risk for contracting COVID-19 than others, the startling evidence only points out the fear of the unknown- it could be completely possible to catch two strains at once.

The evidence, at this point, remains bleak at the moment and is subject to further investigation. Even so, what are the chances of one being susceptible to such a scenario? If so, what should we know about the same?

The incidents of co-infection, or developing two strains of the virus at the same time are isolated incidents but do have a lot of similarities in question.

In the first case, wherein the older woman from Belgium was found to have contracted two virus strains- the Alpha variant (first said to have originated in the United Kingdom) and the Beta variant (detected in South Africa). The woman, who had been admitted to a hospital for an injury went for a routine PCR test which diagnosed the co-infection. The woman rapidly developed respiratory symptoms in a matter of 5 days, and consequently died. Investigations revealed that the woman had not been vaccinated.

This thus became one of the first documented cases of COVID coinfection globally. Further findings revaled that the woman had contracted the virus when both of the strains were in circulation across Belgium.

However, this isn't the first time cases of coinfection have been suspected. Months before, scientists narrowed down on patients from Brazil who were found to test positive for two different variants, including a variant of concern, Gamma variant.

Contrastingly, unlike the Belgian woman, patients in Brazil had less severe outcomes, did not seem to have been impacted by the variants of concerns, and recovered without requiring hospitalization.

Another case of coinfection, from Portugal, was seen to have impacted a patient who was seemingly recovering from a pre-existing COVID-19 infection and caught on another variant. This, researchers, feel led to prolonged viral shedding and severe outcomes for the patient, a teenager with healthy outcomes.

While these are the few 'rare' cases of COVID coinfection reported globally, scientists do believe that coinfections, especially with respiratory viruses aren't that uncommon, and right now is the time to delve more research into safeguarding populations from this added risk while cases surge. RNA viruses such as influenza and hepatitis C commonly mutate and are known to lead to coinfections.

Since viruses are known to evolve and mutate over time, they also lead to mutations that pose a risk to us. While not all mutations are scary, the ones that are capable of evading natural immune response pose the highest risk of infection. For example, an individual's immune response, and the behaviour of the variant could hold clues to why people, in the above documented cases could be reacting so differently and had varied severe outcomes.

There's also a phenomenon that differentiates risk factors pertaining to coronavirus infection. As experts say, coronaviruses can also undergo large changes in their genetic sequence by a process called recombination. When two viruses infect the same cell, they can swap large parts of their genomes with each other and create completely new sequences.

Even so, while coronavirus has a lower known risk of mutating, the possibility of coinfections have pegged concerns of the virus acquiring more mutations rapidly than ever, and the urgent need for more genomic testing and sequencing, which is not happening everywhere.

It should be remembered that coinfection, a rare possibility is still subject to further investigations.

Scientists are studying into the risks, but it has still emerged that vaccination paves the way for fewer severe outcomes and risk of infection. While the Belgium woman who died from a coinfection was unvaccinated, scientists also believe that vaccination would help mitigate the risks of future variants propping up and taming down risks of coinfection.

As with the risk of contracting COVID-19, the risks of coinfection could be the highest for the ones who are susceptible to frail immunity and health issues. Age-related waning immunity, a deficient immune response could be increasing risk factors.

Individual immune response could also be putting one at a more heightened risk for coinfection. While the findings are preliminary in nature, more research is needed to conclude the same.

Low vaccination rates, globally, pose a heavy risk to fueling the continued spread of coronavirus infections. The only thing that could really help minimize the risk of coinfection, mutants emerging is rampant vaccination. In the forthcoming months, we could also see more effective booster shots or universal COVID-19 vaccine shots that could work against all variants of concerns.

The rise in coinfection cases- even if rare only point out why we cannot be complacent with our approach and take COVID-19 lightly.

While countries like India stand at a critical juncture of diminishing second wave and an emerging third wave of infections, there shouldn't be a drop in COVID-appropriate measures and hygiene factors right now. As long as vaccinations continue to happen at a good rate, and crucial preventive measures are being followed, our fight against COVID-19 can be successful. Vaccination, as proven can also mitigate the risk of severe outcomes and mortality with emerging variants of concerns.