Outcomes of SARS-CoV-2 Reinfection / Preprint now published: Acute and postacute sequelae associated with SARS-CoV-2 reinfection, 2022, Al-Aly et al.

Outcomes of SARS-CoV-2 Reinfection
Preprint, Open access: https://www.researchsquare.com/article/rs-1749502/v1

Discusses the risk of long Covid from reinfection. They find that a second infection carries additional risk for long Covid.

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.

 

The graphs in this are concerning, to say the least. Not only are subsequent infections producing higher risk of everything they tracked but vaccination doesn't seem to be at all that impactful to the process. This suggests the entire strategy with Covid has completely failed and unlikely most diseases we don't build up immunity for the future we just get more ill everytime we catch it.

 

"Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention."

This is very worrying in the context of large numbers in society thinking 'covid is over' so there is no need to mask or physically distance etc.

As well as the personal impact, I cannot imagine what this is going to do to the already overwhelmed health and care services. We know that LC services barely exist.

I think there is a gap in the messaging. Vaccines will not be sufficient to protect us from especially disease even if they provide some initial protection. Whose job is it to correct the messaging? Does it need correcting?

 

I'm disappointed they didn't break down their findings by vaccination status. Eyeballing the chart, it seems like vaccinated outcomes are similar or even worse than vaccinated. We know vaccination reduces the risk based on studies designed to do that. My guess is that this study can't give accurate results because it doesn't correct for people in poorer health being more likely to get vaccinated.