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If you are infected again, would the second infection be more serious?

During viral infection, the rule of thumb is that infection will lead to the development of a memory antibody response that is protective against future infection.

However, for some viruses, like dengue virus, the phenomenon of antibody-dependent enhancement (ADE) of infection has been described, where antibodies from the first infection help worsen infection with a different dengue strain during the second infection. There is evidence that this may occur during coronavirus infection and has been studied in regard to the SARS virus. However, it remains unclear if ADE is also playing a role in the current novel coronavirus outbreak. More studies are needed to determine if this is happening with SARS-CoV-2, the COVID-19 virus.

References

https://jvi.asm.org/content/94/5/e02015-19

https://www.ncbi.nlm.nih.gov/pubmed/32092539

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019510/

Drafted 20 March 2020