Disease severity during SARS-COV-2 reinfection: a nationwide study

Anna A. Mensah; Joanne Lacy; Julia Stowe; Giulia Seghezzo; Ruchira Sachdeva; Ruth Simmons; Antoaneta Bukasa; Shennae O'Boyle; Nick Andrews; Mary Ramsay; Helen Campbell; Kevin Brown

doi:10.1016/j.jinf.2022.01.012

Disease severity during SARS-COV-2 reinfection: a nationwide study

Anna A. Mensah, Joanne Lacy, Julia Stowe, Giulia Seghezzo, Ruchira Sachdeva, Ruth Simmons, Antoaneta Bukasa, Shennae O'Boyle, Nick Andrews, Mary Ramsay, Helen Campbell^*, Kevin Brown

^*Corresponding author for this work

UK Health Security Agency

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Abstract

Objective: We aimed to look at the burden of disease caused by SARS-COV-2 reinfections and identified potential risk factors for disease severity.

Methods: We used national surveillance data to collect information on all SARS-CoV-2 primary infection and suspected reinfection cases between January 2020 until early May 2021. Reinfection cases were positive COVID-19 PCR or antigen test, 90 days after their first COVID-19 positive test. We collected information on case demographics, hospital and ICU admission, immunisation status and if individuals were at risk of complication for COVID-19.

Results: Deaths reported within 28 days of testing positive were 61% (95% confidence interval: 56% to 65%) lower in suspected COVID-19 reinfection than primary infection cases. In the unvaccinated cohort, reinfections were associated with 49% (37% to 58%) lower odds of hospital admission in cases aged 50 to 65 years in the population not identified at risk of complication for COVID-19, and 34% (17% to 48%) in those at risk. ICU admission at reinfection compared to primary infection decreased 76% (55% to 87%). Individuals at risk and those aged below 50 years, who received at least 1 dose of vaccine against COVID-19, were 62% (39% to 74%) and 58% (24% to 77%) less likely to get admitted to hospital at reinfection, respectively.

Conclusion: Prior SARS-CoV-2 infection was associated with lower odds of dying, and both prior infection and immunisation showed a protective effect against severe disease in selected populations. Older age, sex and underlying comorbidities appeared as principal risk factors for illness severity at reinfection.

Funding: PHE/UKHSA

Original language	English
Pages (from-to)	542-550
Number of pages	9
Journal	Journal of Infection
Volume	84
Issue number	4
Early online date	25 Jan 2022
DOIs	https://doi.org/10.1016/j.jinf.2022.01.012
Publication status	Published - 8 Apr 2022

Bibliographical note

Funding Information: PHE/UKHSA

Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Publisher Copyright: Crown Copyright ©2022 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Anna A. Mensah, Joanne Lacy, Julia Stowe, Giulia Seghezzo, Ruchira Sachdeva, Ruth Simmons, Antoaneta Bukasa, Shennae O'Boyle, Nick Andrews, Mary Ramsay, Helen Campbell, Kevin Brown, Disease severity during SARS-COV-2 reinfection: a nationwide study, Journal of Infection, Volume 84, Issue 4, 2022, Pages 542-550, ISSN 0163-4453.

DOI: https://doi.org/10.1016/j.jinf.2022.01.012.

Keywords

COVID-19
Disease severity
Immunisation
Primary infection
Reinfection
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Mensah2022DiseaseSeverityDuringSARSCOV2ReinfectionANationwideStudyJInfectFinal published version, 611 KBLicence: CC BY-NC-ND

Cite this

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title = "Disease severity during SARS-COV-2 reinfection: a nationwide study",

abstract = "Objective: We aimed to look at the burden of disease caused by SARS-COV-2 reinfections and identified potential risk factors for disease severity. Methods: We used national surveillance data to collect information on all SARS-CoV-2 primary infection and suspected reinfection cases between January 2020 until early May 2021. Reinfection cases were positive COVID-19 PCR or antigen test, 90 days after their first COVID-19 positive test. We collected information on case demographics, hospital and ICU admission, immunisation status and if individuals were at risk of complication for COVID-19. Results: Deaths reported within 28 days of testing positive were 61% (95% confidence interval: 56% to 65%) lower in suspected COVID-19 reinfection than primary infection cases. In the unvaccinated cohort, reinfections were associated with 49% (37% to 58%) lower odds of hospital admission in cases aged 50 to 65 years in the population not identified at risk of complication for COVID-19, and 34% (17% to 48%) in those at risk. ICU admission at reinfection compared to primary infection decreased 76% (55% to 87%). Individuals at risk and those aged below 50 years, who received at least 1 dose of vaccine against COVID-19, were 62% (39% to 74%) and 58% (24% to 77%) less likely to get admitted to hospital at reinfection, respectively. Conclusion: Prior SARS-CoV-2 infection was associated with lower odds of dying, and both prior infection and immunisation showed a protective effect against severe disease in selected populations. Older age, sex and underlying comorbidities appeared as principal risk factors for illness severity at reinfection. Funding: PHE/UKHSA",

keywords = "COVID-19, Disease severity, Immunisation, Primary infection, Reinfection, SARS-CoV-2",

author = "Mensah, {Anna A.} and Joanne Lacy and Julia Stowe and Giulia Seghezzo and Ruchira Sachdeva and Ruth Simmons and Antoaneta Bukasa and Shennae O'Boyle and Nick Andrews and Mary Ramsay and Helen Campbell and Kevin Brown",

note = "Funding Information: PHE/UKHSA Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Publisher Copyright: Crown Copyright {\textcopyright}2022 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Anna A. Mensah, Joanne Lacy, Julia Stowe, Giulia Seghezzo, Ruchira Sachdeva, Ruth Simmons, Antoaneta Bukasa, Shennae O'Boyle, Nick Andrews, Mary Ramsay, Helen Campbell, Kevin Brown, Disease severity during SARS-COV-2 reinfection: a nationwide study, Journal of Infection, Volume 84, Issue 4, 2022, Pages 542-550, ISSN 0163-4453. DOI: https://doi.org/10.1016/j.jinf.2022.01.012.",

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AU - Mensah, Anna A.

AU - Lacy, Joanne

AU - Stowe, Julia

AU - Seghezzo, Giulia

AU - Sachdeva, Ruchira

AU - Simmons, Ruth

AU - Bukasa, Antoaneta

AU - O'Boyle, Shennae

AU - Andrews, Nick

AU - Ramsay, Mary

AU - Campbell, Helen

AU - Brown, Kevin

N1 - Funding Information: PHE/UKHSA Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Publisher Copyright: Crown Copyright ©2022 Published by Elsevier Ltd on behalf of The British Infection Association. Citation: Anna A. Mensah, Joanne Lacy, Julia Stowe, Giulia Seghezzo, Ruchira Sachdeva, Ruth Simmons, Antoaneta Bukasa, Shennae O'Boyle, Nick Andrews, Mary Ramsay, Helen Campbell, Kevin Brown, Disease severity during SARS-COV-2 reinfection: a nationwide study, Journal of Infection, Volume 84, Issue 4, 2022, Pages 542-550, ISSN 0163-4453. DOI: https://doi.org/10.1016/j.jinf.2022.01.012.

PY - 2022/4/8

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N2 - Objective: We aimed to look at the burden of disease caused by SARS-COV-2 reinfections and identified potential risk factors for disease severity. Methods: We used national surveillance data to collect information on all SARS-CoV-2 primary infection and suspected reinfection cases between January 2020 until early May 2021. Reinfection cases were positive COVID-19 PCR or antigen test, 90 days after their first COVID-19 positive test. We collected information on case demographics, hospital and ICU admission, immunisation status and if individuals were at risk of complication for COVID-19. Results: Deaths reported within 28 days of testing positive were 61% (95% confidence interval: 56% to 65%) lower in suspected COVID-19 reinfection than primary infection cases. In the unvaccinated cohort, reinfections were associated with 49% (37% to 58%) lower odds of hospital admission in cases aged 50 to 65 years in the population not identified at risk of complication for COVID-19, and 34% (17% to 48%) in those at risk. ICU admission at reinfection compared to primary infection decreased 76% (55% to 87%). Individuals at risk and those aged below 50 years, who received at least 1 dose of vaccine against COVID-19, were 62% (39% to 74%) and 58% (24% to 77%) less likely to get admitted to hospital at reinfection, respectively. Conclusion: Prior SARS-CoV-2 infection was associated with lower odds of dying, and both prior infection and immunisation showed a protective effect against severe disease in selected populations. Older age, sex and underlying comorbidities appeared as principal risk factors for illness severity at reinfection. Funding: PHE/UKHSA

AB - Objective: We aimed to look at the burden of disease caused by SARS-COV-2 reinfections and identified potential risk factors for disease severity. Methods: We used national surveillance data to collect information on all SARS-CoV-2 primary infection and suspected reinfection cases between January 2020 until early May 2021. Reinfection cases were positive COVID-19 PCR or antigen test, 90 days after their first COVID-19 positive test. We collected information on case demographics, hospital and ICU admission, immunisation status and if individuals were at risk of complication for COVID-19. Results: Deaths reported within 28 days of testing positive were 61% (95% confidence interval: 56% to 65%) lower in suspected COVID-19 reinfection than primary infection cases. In the unvaccinated cohort, reinfections were associated with 49% (37% to 58%) lower odds of hospital admission in cases aged 50 to 65 years in the population not identified at risk of complication for COVID-19, and 34% (17% to 48%) in those at risk. ICU admission at reinfection compared to primary infection decreased 76% (55% to 87%). Individuals at risk and those aged below 50 years, who received at least 1 dose of vaccine against COVID-19, were 62% (39% to 74%) and 58% (24% to 77%) less likely to get admitted to hospital at reinfection, respectively. Conclusion: Prior SARS-CoV-2 infection was associated with lower odds of dying, and both prior infection and immunisation showed a protective effect against severe disease in selected populations. Older age, sex and underlying comorbidities appeared as principal risk factors for illness severity at reinfection. Funding: PHE/UKHSA

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Disease severity during SARS-COV-2 reinfection: a nationwide study

Abstract

Bibliographical note

Keywords

UN SDGs

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