tetano
Editor, Senior Moderator
Clin Infect Dis
. 2025 Jun 18:ciaf225.
doi: 10.1093/cid/ciaf225. Online ahead of print. The Effect of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection on Long-Term Symptoms in the Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE)
John J Openshaw[SUP] 1 2 [/SUP], Ji Chen[SUP] 3 [/SUP], Robert Rodriguez[SUP] 4 [/SUP], Michael Gottlieb[SUP] 5 [/SUP], Kalyani McCullough[SUP] 2 [/SUP], Michelle Santangelo[SUP] 5 [/SUP], Mandy J Hill[SUP] 6 [/SUP], Kristyn Gatling[SUP] 7 [/SUP], Ahamed H Idris[SUP] 8 [/SUP], Samuel McDonald[SUP] 8 [/SUP], Lauren E Wisk[SUP] 9 [/SUP], Jonathan Dyal[SUP] 10 [/SUP], Ralph C Wang[SUP] 11 [/SUP], Kristin L Rising[SUP] 12 [/SUP], Efrat Kean[SUP] 12 [/SUP], Kelli N O'Laughlin[SUP] 13 [/SUP], Kari A Stephens[SUP] 14 [/SUP], Caitlin Malicki[SUP] 15 [/SUP], Zhenqiu Lin[SUP] 3 [/SUP], Erica S Spatz[SUP] 3 [/SUP], Huihui Yu[SUP] 3 [/SUP], Robert A Weinstein[SUP] 7 [/SUP], Joann Elmore[SUP] 9 [/SUP]
Affiliations
Background: The clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.
Methods: Individuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue severity score ≥25) and the presence of organ system symptoms 3-6 months after the last infection.
Results: The analysis included 886 individuals, 415 (46.8%) of whom experienced reinfection. For individuals who experienced their first infections in either the pre-Delta or Delta periods, the odds of having ≥3 symptoms 3-6 months after their most recent infection was lower in those reinfected than those with a single infection (weighted adjusted odds ratio, 0.45 [95% confidence interval, .21-.95] and 0.51 [.32-.79], respectively). However, in individuals reporting their first infection during the Omicron wave, the odds of reporting ≥3 symptoms after the most recent infection was higher in those reinfected than in those with a single infection (weighted adjusted odds ratio, 1.54 [95% confidence interval, 1.02-2.34]).
Conclusions: The timing of initial infection, reinfection, and the variants involved may play important roles in longer-term clinical outcomes. Repeated infection with Omicron variants may increase the risk of long-term symptoms.
Keywords: COVID-19; SARS-CoV-2; long COVID; post-COVID-19 syndrome; reinfection.
. 2025 Jun 18:ciaf225.
doi: 10.1093/cid/ciaf225. Online ahead of print. The Effect of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection on Long-Term Symptoms in the Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE)
John J Openshaw[SUP] 1 2 [/SUP], Ji Chen[SUP] 3 [/SUP], Robert Rodriguez[SUP] 4 [/SUP], Michael Gottlieb[SUP] 5 [/SUP], Kalyani McCullough[SUP] 2 [/SUP], Michelle Santangelo[SUP] 5 [/SUP], Mandy J Hill[SUP] 6 [/SUP], Kristyn Gatling[SUP] 7 [/SUP], Ahamed H Idris[SUP] 8 [/SUP], Samuel McDonald[SUP] 8 [/SUP], Lauren E Wisk[SUP] 9 [/SUP], Jonathan Dyal[SUP] 10 [/SUP], Ralph C Wang[SUP] 11 [/SUP], Kristin L Rising[SUP] 12 [/SUP], Efrat Kean[SUP] 12 [/SUP], Kelli N O'Laughlin[SUP] 13 [/SUP], Kari A Stephens[SUP] 14 [/SUP], Caitlin Malicki[SUP] 15 [/SUP], Zhenqiu Lin[SUP] 3 [/SUP], Erica S Spatz[SUP] 3 [/SUP], Huihui Yu[SUP] 3 [/SUP], Robert A Weinstein[SUP] 7 [/SUP], Joann Elmore[SUP] 9 [/SUP]
Affiliations
- PMID: 40576557
- DOI: 10.1093/cid/ciaf225
Background: The clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.
Methods: Individuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue severity score ≥25) and the presence of organ system symptoms 3-6 months after the last infection.
Results: The analysis included 886 individuals, 415 (46.8%) of whom experienced reinfection. For individuals who experienced their first infections in either the pre-Delta or Delta periods, the odds of having ≥3 symptoms 3-6 months after their most recent infection was lower in those reinfected than those with a single infection (weighted adjusted odds ratio, 0.45 [95% confidence interval, .21-.95] and 0.51 [.32-.79], respectively). However, in individuals reporting their first infection during the Omicron wave, the odds of reporting ≥3 symptoms after the most recent infection was higher in those reinfected than in those with a single infection (weighted adjusted odds ratio, 1.54 [95% confidence interval, 1.02-2.34]).
Conclusions: The timing of initial infection, reinfection, and the variants involved may play important roles in longer-term clinical outcomes. Repeated infection with Omicron variants may increase the risk of long-term symptoms.
Keywords: COVID-19; SARS-CoV-2; long COVID; post-COVID-19 syndrome; reinfection.