Researchers in Belgium found that a woman died of Covid-19 after contracting two different coronavirus variants at the same time, drawing potential concerns of co-infections and other complications from variants.

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Background

According to the case report, a 90-year-old Belgian woman was admitted to a hospital after a series of falls. At the time of admission, the woman's breathing and blood oxygen levels were normal. However, a SARS-CoV-2 screening test came back "strongly positive."

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Subsequent PCR tests indicated the woman was infected with two coronavirus variants of concerns at the same time—the alpha variant, which was first identified in the United Kingdom, and the beta variant, which was first identified in South Africa. Secondary tests confirmed the results.

Over the course of her five-day hospital stay, the woman quickly developed worsening respiratory symptoms and eventually passed away. The woman's case study was presented at the European Congress of Clinical Microbiology & Infectious Diseases.

Anne Vankeerberghen—a molecular biologist at OLV Hospital in Belgium and the lead author of the case report—said, "Both these variants were circulating in Belgium at the time, so it is likely that the lady was co-infected with different viruses from two different people." However, Vankeerberghen said researchers do not know how the woman became infected with the two variants.

Cases of double infection

While researchers have called this case "exceptional," as the patient is the first confirmed case of a double infection of coronavirus variants, similar cases of double infections have been reported.

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For instance, researchers identified people who had two coronavirus variants in their system simultaneously earlier this year in Brazil, although the study has not been published yet. Additionally, the researchers say previous studies have found evidence of people being infected with two different influenza virus strains at the same time.

According to Vankeerberghen, the worldwide occurrence of double infections is "probably underestimated due to limited testing for variants of concern and the lack of a simple way to identify co-infections with whole genome sequencing." According to the researchers, increased testing for coronavirus variants "would probably identify more mixed infection and could lead to a better insight for their effect on illness and treatment."

Increasing testing for variants

According to NPR, coronavirus variants have been pinpointed as the cause of localized surges of new Covid-19 cases in the United States, even as high vaccinations in some areas have helped curb the spread. The Biden administration in April announced that it would increase efforts to track and test for coronavirus variants.

In particular, health experts say it is "vital" to identify the variants that are responsible for thousands of breakthrough infections, which have occurred in those who are fully vaccinated. (Chappell, NPR, 7/12; Carbajal, Becker's Hospital Review, 7/12)