Preprint - Outcomes of SARS-CoV2 Reinfection

[sharon sanders]

My formatting and bolding for easier reading.



Outcomes of SARS-CoV-2 Reinfection

Ziyad Al-Aly[SUP]1[/SUP]

ORCID

Email

Benjamin Bowe[SUP]2[/SUP]

Yan Xie[SUP]2[/SUP]

ORCID

[SUP]1 [/SUP]Washington University School of Medicine,

[SUP]2 [/SUP]VA Saint Louis Health Care System





This is a preprint; it has not been peer reviewed by a journal.



https://doi.org/10.21203/rs.3.rs-1749502/v1

This work is licensed under a CC BY 4.0 License


Abstract


First infection with SARS-CoV-2 is associated with increased risk of acute and post-acute death and sequelae in the pulmonary and extrapulmonary organ systems. However, whether reinfection adds to the risk incurred after the first infection is not clear. Here we use the national health care databases of the US Department of Veterans Affairs to build a cohort of people with first infection (n = 257,427), reinfection (2 or more infections, n = 38,926), and a non-infected control group (n = 5,396,855) to estimate risks and 6-month burdens of all-cause mortality, hospitalization, and a set of pre-specified incident outcomes.

We show that compared to people with first infection, reinfection contributes additional risks of all-cause mortality, hospitalization, and adverse health outcomes in the pulmonary and several extrapulmonary organ systems (cardiovascular disorders, coagulation and hematologic disorders, diabetes, fatigue, gastrointestinal disorders, kidney disorders, mental health disorders, musculoskeletal disorders, and neurologic disorders); the risks were evident in those who were unvaccinated, had 1 shot, or 2 or more shots prior to the second infection; the risks were most pronounced in the acute phase, but persisted in the post-acute phase of reinfection, and most were still evident at 6 months after reinfection.

Compared to non-infected controls, assessment of the cumulative risks of repeated infection showed that the risk and burden increased in a graded fashion according to the number of infections. The constellation of findings show that reinfection adds non-trivial risks of all-cause mortality, hospitalization, and adverse health outcomes in the acute and post-acute phase of the reinfection. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.

https://www.researchsquare.com/article/rs-1749502/v1

 

[sharon sanders]

An analysis of the above preprint....



Sabina Vohra-Miller

@SabiVM



New data: Reinfection was found to substantially increase the risk of death, hospitalization, and adverse health outcomes, making strategies preventing reinfection critical. Summary 1/9

ALT
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Sabina Vohra-Miller

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A recent study using the national health care databases of the US Department of Veterans Affairs compared people with first infection, reinfection or no infection. Estimate risks and 6-month burdens of all-cause mortality, hospitalization and other adverse health outcomes. 2/9

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Sabina Vohra-Miller

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1- Reinfection resulted in additional risks of death, hospitalization and adverse health outcomes, including: pulmonary, cardiovascular, coagulation and hematologic, diabetes, fatigue, gastrointestinal, kidney, mental health, musculoskeletal, and neurologic disorders. 3/9

Sabina Vohra-Miller

Sabina Vohra-Miller

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Graph showing hazard ratios and excess burden. 4/9

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Sabina Vohra-Miller

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2- Each additional infection further increased the risk and burden of illness, ie, it increased in a graded fashion according to the number of infections. 5/9

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Sabina Vohra-Miller

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3- Reinfection was associated with higher risk of death, hospitalization and adverse health outcome regardless of vaccination status. 6/9

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4- Risks were most common in the acute phase, but persisted even 6 months post infection. 7/9

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Sabina Vohra-Miller

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Even with mild illness, there are long lasting & deleterious impacts on health, which increases with each reinfection. Utilizing a vaccine+ strategy with multiple layers of protection is critical to avoid reinfections & risks associated with each repeat infection. 8/9

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Sabina Vohra-Miller

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Limitations: - Vaccinated subgroup likely more frail - Repeat infections could be due to inability to seroconvert - Study compares those with reinfections to those without any infection 9/9

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Reference:

researchsquare.com
Outcomes of SARS-CoV-2 Reinfection
First infection with SARS-CoV-2 is associated with increased risk of acute and post-acute death and sequelae in the pulmonary and extrapulmonary organ systems. However, whether reinfection adds to...
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31
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[Emily]

From the study:

We then constructed a non-infected control group. We first identified 5,714,736 VHA users between March 1, 2020 and September 4, 2021 with no record of a positive SARS-CoV-2 test.

I got Covid early in the pandemic before there were any tests available, (wouldn't have gotten one, anyway), while living in a Pacific fleet Navy town. I'm sure there were many others like me with no positive tests who were exposed to the Wuhan strain which I think was an escape from a project to develop a universal coronavirus vaccine. They would erroneously be placed in the non-infected group. I think the earliest strain(s) gave the best immunity. I have not had any problems since then with re-infections or new health problems, and I never had nor will have a Covid vaccine. (A very individual choice based on my own health, lifestyle, and ability to deal with infection.) People like me aren't showing up in these fearsome studies.

This study isn't broken down by age or health conditions, so isn't useful for people trying to determine personal risk. Being a VA study, it would be weighted towards an older population. They said the population was 90% men.

 

[Emily]

"Even with mild illness, there are long lasting & deleterious impacts on health"

Can't find the word "mild" in the study.

 

[JJackson]

Emily the study is broken down by age, health condition and many other categories but you need to look in the supplementary data tables. This was a very unhealthy group. The mean BMI was 30 (the boarder between over weight and obese), 25% had type 2 diabetes, the mean systolic pressure was 130, the mean age was 60, they were on lots of other medications etc.
It is not much of a surprise that each time you catch a disease your cumulative risk across all cases increase, it can never go down. The vaccines have been amazingly effective at doing what they were meant to, reducing severe disease and death. They have also helped reduce the risk of reinfection for a while, a nice ancillary benefit, but this is dependent on high neutralising antibody titers which contract once the acute infection is cleared.

 

[Emily]

Thank you for finding that background, JJackson. Makes sense for a high risk group like that.