ABSTRACT
Background: Repeated SARS-CoV-2 infections are plausible and related published data are scarce. We aimed to identify factors associated with the risk of recurrent (three episodes) laboratory-confirmed symptomatic SARS-CoV-2 infections. Methods: A retrospective cohort study was conducted and 1,700 healthcare workers were enrolled. We used risk ratios (RR) and 95% confidence intervals (CI) to evaluate factors associated with symptomatic SARS-CoV-2 infections. Results: We identified 14 participants with recurrent illness episodes. Therefore, the incidence rate was 8.5 per 10,000 person-months. In multiple model, vaccinated adults (vs. unvaccinated, RR = 1.05 [1.03 - 1.06]) and those with a severe first illness episode (vs mild disease, RR = 1.05 [1.01 - 1.10]) were at increased risk for repeated symptomatic SARS-CoV-2 reinfections. Increasing age showed a protective effect (per each additional year of age: RR = 0.98 [0.97 - 0.99]). Conclusions: Our results suggest that recurrent SARS-CoV-2 infections are rare events in adults and they seem to be determined, partially, by vaccination status and age.
Subject(s)
COVID-19 , Critical Illness , Severe Acute Respiratory SyndromeABSTRACT
BackgroundThere is a major concern regarding the prognosis of coronavirus disease 2019 (COVID-19) in patients who recovered to first-time illness. ObjectiveTo evaluate factors predicting severe symptomatic laboratory-confirmed (reverse transcription-quantitative polymerase chain reaction, RT-qPCR) SARS-COV-2 (severe acute coronavirus-2) reinfection. MethodWe conducted a nationwide retrospective cohort study in Mexico and data from 258 reinfection cases (at least 28 days between both episodes onset) were analyzed. We used risk ratios (RR) and 95% confidence intervals (CI) to evaluate predictors of severe (dyspnea requiring hospital admission) secondary SARS-COV-2 infection. ResultsThe risk of severe disease was 14.7% and the observed overall fatality rate was 4.3%. Patients with more serious primary disease were more likely to develop severe symptoms (39.5% vs. 5.5%, p < 0.001) during reinfection. In multiple analysis, factors associated with an increased risk of severe symptomatic SARS-COV-2 reinfection were increasing age (RR per year = 1.007, 95% CI 1.003-1.010), comorbidities (namely obesity [RR = 1.12, 95% CI 1.01-1.24], asthma [RR = 1.26, 95% CI 1.06-1.50], type 2 diabetes mellitus [RR = 1.22, 95% CI 1.07 - 1.38] and previous severe laboratory-confirmed COVID-19 (RR = 1.20, 95% CI 1.03-1.39). ConclusionsTo the best of our knowledge this is the first study evaluating disease outcomes in a large set of laboratory-positive cases of symptomatic SARS-COV-2 reinfection and factors associated with illness severity was characterized. Our results may contribute to the current knowledge of SARS-COV-2 pathogenicity and to identify populations at increased risk of a poorer outcome after reinfection.
Subject(s)
COVID-19ABSTRACT
Objective: To identify factors predicting symptomatic laboratory-positive SARS-COV-2 reinfection. Method: We conducted a nationwide retrospective cohort study and data from 99,993 confirmed cases of COVID-19 were analyzed. Results: The overall risk of reinfection (28 or more elapsed days between both episodes onset) was 0.21%, and older subjects and those with mild primary disease were at reduced risk of reinfection. Healthcare workers and immunosuppressed or renal patients had at greater risk of SARS-COV-2 reinfection. Conclusions: If replicated in other populations, these results may be useful to prioritize efforts focusing on the reduction of SARS-COV-2 spread and the related burden.
Subject(s)
COVID-19ABSTRACT
ObjectiveTo identify factors predicting severe coronavirus disease 2019 (COVID-19) in adolescent and adult patients with laboratory-positive (quantitative reverse-transcription polymerase chain reaction) infection. MethodsA retrospective cohort study took place, and data from 740 subjects, from all 32 states of Mexico, were analyzed. The association between the studied factors and severe (dyspnea requiring hospital admission) COVID-19 was evaluated through risk ratios (RRs) and 95% confidence intervals (CIs). ResultsSevere illness was documented in 28% of participants. In multiple analysis, male gender (RR = 1.13, 95% CI 1.06 - 1.20), advanced age ([reference: 15 - 29 years old] 30 - 44, RR = 1.02, 95% CI 0.94 - 1.11; 45 - 59, RR = 1.26, 95% CI 1.15 - 1.38; 60 years or older, RR = 1.44, 95% CI 1.29 - 1.60), chronic kidney disease (RR = 1.31, 95% CI 1.04 - 1.64) and thoracic pain (RR = 1.16, 95% CI 1.10 - 1.24) were associated with an increased risk of severe disease. ConclusionsTo the best of our knowledge, this is the first study evaluating predictors of COVID-19 severity in a large subset of the Latin-American population. It is also the first in documenting gender-related differences regarding the severity of the illness. These results may be useful for health care protocols for the early detection and management of COVID-19 patients that may benefit from opportune and specialized supportive medical treatment.