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Acute and postacute sequelae associated with SARS-CoV-2 reinfection
Benjamin Bowe1,2, Yan Xie1,2, Ziyad Al-Aly3,4,5,6,7
1Clinical Epidemiology Center, Research and Development Service, Veteran Affairs Saint Louis Health Care System, St. Louis, MO, USA.
Nature Medicine
|November 10, 2022
Summary
COVID-19 reinfection significantly increases the risk of death, hospitalization, and long-term organ damage. These risks persist regardless of vaccination status, highlighting the need for reinfection prevention strategies.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- First severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is linked to increased risks of death and organ system sequelae.
- The impact of SARS-CoV-2 reinfection on these risks remains unclear.
Purpose of the Study:
- To evaluate the additional risks of death, hospitalization, and incident sequelae associated with SARS-CoV-2 reinfection.
- To compare risks between individuals with no reinfection, reinfection, and no infection.
Main Methods:
- Utilized the US Department of Veterans Affairs national healthcare database.
- Constructed cohorts of individuals with one SARS-CoV-2 infection (n=443,588), reinfection (n=40,947), and no infection (n=5,334,729).
- Employed inverse probability-weighted survival models to estimate risks and 6-month burdens.
Main Results:
- Reinfection significantly increased risks of death (HR=2.17) and hospitalization (HR=3.32) compared to no reinfection.
- Additional risks included pulmonary, cardiovascular, diabetes, kidney, and neurological disorders, persisting for 6 months.
- Risks were evident regardless of vaccination status and increased with the number of infections.
Conclusions:
- SARS-CoV-2 reinfection poses substantial additional risks for adverse health outcomes, including death and multi-organ sequelae.
- These risks are present in both acute and post-acute phases and are independent of vaccination status.
- Strategies to prevent SARS-CoV-2 reinfection are crucial for reducing the overall burden of disease.
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