COVID-19 reinfections likely match severity of initial infections, study finds.

John McMillan, Lumienta

A comprehensive analysis of electronic health records from over 3 million Americans has provided valuable insights into COVID-19 reinfections and their relationship with Long COVID. The study, published in Communications Medicine, examined data from 212,984 individuals who experienced reinfections between March 2020 and March 2023.

Key findings include:

  • Reinfection Severity: The severity of initial COVID-19 infection appears to be associated with the severity of subsequent reinfections. About 27% of those who required hospitalization during their first infection also needed hospital care for reinfection. However, 87% of individuals with mild initial cases also experienced mild reinfections.
  • Long COVID Incidence: Surprisingly, Long COVID diagnoses were more common following initial infections than reinfections within the same variant epoch. This challenges the assumption that reinfections necessarily increase Long COVID risk.
  • Reinfection Timing: Most reinfections occurred during the Omicron variant epoch (late 2021-early 2022), likely due to waning immunity and increased transmissibility of new variants.
  • Multiple Reinfections: While most reinfected individuals (203,735) had only one reinfection, a small group (478) experienced three or more infections.
  • Biomarkers: Lower albumin levels were observed after initial infection and leading up to reinfection, suggesting a potential predictor of reinfection risk.
  • Demographic Patterns: Reinfected individuals tended to be younger and more likely to be female. Those with higher comorbidity scores were at increased risk for reinfection.
  • Vaccination Impact: Fewer reinfected patients (14.3%) had documented vaccination prior to their initial infection compared to those without reinfection (25.0%), indicating a protective effect of vaccination.

The study’s findings have important implications for clinical practice and public health strategies. They underscore the need for continued vigilance in preventing SARS-CoV-2 transmission, even among those previously infected. The association between initial and reinfection severity suggests that healthcare providers should consider a patient’s prior COVID-19 history when assessing risk.

Limitations of the study include reliance on electronic health records, which may not capture all COVID-19 cases, particularly those diagnosed through home testing. Additionally, the analysis was limited to the first reinfection due to the small number of individuals with multiple reinfections.

 

This article is based on information from Communications Medicine under a Creative Commons license. Read the original article.

 

More information: Hadley, E., Yoo, Y.J., Patel, S. et al. Insights from an N3C RECOVER EHR-based cohort study characterizing SARS-CoV-2 reinfections and Long COVID. Commun Med 4, 129 (2024). https://doi.org/10.1038/s43856-024-00539-2

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