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Acute and postacute sequelae associated with SARS-CoV-2 reinfection

Benjamin Bowe, Yan Xie, Ziyad Al-Aly

2022 · Nature Medicine

Statistics & probabilityDatabasesBiology & medicine
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From the abstract

Abstract First infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risk of acute and postacute death and sequelae in various organ systems. Whether reinfection adds to risks incurred after first infection is unclear. Here we used the US Department of Veterans Affairs’ national healthcare database to build a cohort of individuals with one SARS-CoV-2 infection ( n = 443,588), reinfection (two or more infections, n = 40,947) and a noninfected control ( n = 5,334,729). We used inverse probability-weighted survival models to estimate risks and 6-month burdens of death, hospitalization and incident sequelae. Compared to no reinfection, reinfection contributed additional risks of death (hazard ratio (HR) = 2.17, 95% confidence intervals (CI) 1.93–2.45), hospitalization (HR = 3.32, 95% CI 3.13–3.51) and sequelae including pulmonary, cardiovascular, hematological, diabetes, gastrointestinal, kidney, mental health, musculoskeletal and neurological disorders. The risks were evident regardless of vaccination status. The risks were most pronounced in the acute phase but persisted in the postacute phase at 6 months. Compared to noninfected controls, cumulative risks and burdens of repeat infection increased according to the number of infections. Limitations included a cohort of mostly white males. The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.

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Animats
Neutral mention · rule
> That assumes likelihood of getting long COVID doesn't drop after successive infections. It's not looking good. December 2022 study [1][2]: "The risk of hospitalization, organ damage, and death rises markedly with repeat COVID-19 infection. Assistant professor of medicine Amy Barczak shared a Nature study that used data from the Veteran’s Administration to assess the cumulative risk of post-infection effects in people with one, two, and three or more SARS-CoV-2 infections, as compared to noninfected controls. The data show a consistent pattern of increased likelihood of hospitalization, cardiovascular effects, clotting and other blood disorders, diabetes, fatigue,…
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gastrointestinal distress, kidney damage, mental health effects such as depression, musculoskeletal damage, neurological deficits, and pulmonary damage with each episode. Prior infection does not change the course of disease in subsequent infections, just the risk of severe complications." [1] https://www.harvardmagazine.com/2022/12/covid-reinfection [2] https://www.nature.com/articles/s41591-022-02051-3
Original comment Long Covid: major findings, mechanisms and recommendations
seydor
Neutral mention · rule
I took 3 doses of vaccine but it is no longer effective at preventing infections. Studies that keep coming out show that Covid can have a lot of damaging consequences every time you get infected and they accumulate (https://www.nature.com/articles/s41591-022-02051-3). I have a job and lifestyle that allows me to limit crowded spaces by a lot during wintertime. I will try to avoid getting covid ever again as much as possible, and the vaccine doesn't help much in that. I think the danger from vaccine is very small, but , as in everything, i want to wait a few years before i can trust it. But to those that plan to get immunized by simply getting Covid again I 'd say "good luck" because they are going to need it
Original comment Autopsy-based characterization of myocarditis after anti-SARS-CoV-2-vaccination
ejstronge
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> It's even worse than that; hazard ratio increases significantly with each re-infection https://www.nature.com/articles/s41591-022-02051-3 I don’t think this paper is a great source for that idea - the ratio of people with one infection (440,000) to people with three or more infections (1,000) is so different that I wonder if demographics or behavioral characteristics differ between the groups. Empirically, their conclusion can’t really be true or each COVID-wave would be worse than the preceding one
Original comment China state CCTV avoids crowd close ups at the World Cup
seydor
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As others said the booster doesnt seem to be much different than previous vaccines, and overall they are all low efficacy against infection. https://www.ecdc.europa.eu/en/publications-data/interim-anal... https://www.science.org/doi/10.1126/science.abq1841 However, there is a worrying stream of research indicating that covid outcomes are worse than we generally think they are, even in mild infections. https://onlinelibrary.wiley.com/doi/10.1002/jmv.28187 https://www.nature.com/articles/s41590-021-01113-x https://publications.aap.org/pediatrics/article/150/5/e20220...? And every reinfection seems to make it worse, so this thing should not be allowed to become 'endemic' https://www.nature.com/articles/s41591-022-02051-3 So it seems like other, more effective measures to reduce infections are more likely to keep people healthy rather than trying to reduce the severity of symptoms (which is what vaccines do atm)
Original comment Harvard mandates the bivalent Omicron-specific Covid-19 booster

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