Exploring the Link Between Repeat COVID Infections and Higher Risks of Severe Illness and Long COVID

February 28, 2023
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There is an alarming increase in the number of SARS-CoV-2 or COVID-19 reinfections. The news dashes all hope of immunity by vaccination or having been infected by a prior variation. As the number of people being re-infected increases, many people may be led to believe that their symptoms are not as severe, and there is a lot of evidence to substantiate that claim. However, the jury is still out on this as reinfection cases continue to rise.

At present, there is limited evidence to suggest that reinfected individuals will recover within a couple of days. Some are having a rougher time than others, and thus it is hard to predict at present. Then there are instances of new viral strains on the rise, which are more contagious and, therefore, an urgent priority for medical experts.

Health Risk Studies

The first study to research the health risks associated with repeat infections was published in November 2022 and was led by Ziyad Al-Aly, at Washington University in St. Louis. The study showed that those who were reinfected were at a higher risk of losing their lives and were at a higher likelihood of needing to be hospitalized compared to those who were only infected once, which is regardless of if they were vaccinated.

The team drew their conclusion from data that comes from over half a million COVID patients who were treated by the US Department of Veterans Affairs (VA) in 2020. It is worth noting that around 10% of those in the data had been infected with SARS-CoV-2 up to four times. Plus, some reported symptoms for six months, with the severity worsening with each new infection episode of COVID.

In light of the findings Al-Aly emphasized that repeat infections are both in the acute and long phases of the infection. But there are caveats to the rest. For instance, the VA patients were all or mostly older men who were 63 years of age. Not to mention they all hand preexisting health issues, including heart disease. All factors are known to worsen a COVID infection, according to Al-Aly considerably.

However, critics of the study point out that the expectation that repeat infection would be milder because of the body’s immunity built up from the initial infection. Results from the study still require validation across other populations. Thus, more research on cases of reinfections needs to be done, especially amongst those exposed to the new newer variants of the virus.

Critics also note that many hospitalizations and, consequently, deaths from COVID are among the elderly and those who aren’t vaccinated or perhaps their immunity is compromised. But for most people outside these small groups, subsequent infections should be milder, say critics of the study. Plus, there could be immunological impacts that are presently not fully understood.

The latest findings support Al-Aly’s previous research and highlight the potential severity of COVID-19 reinfections, as well as the heightened risk faced by those already vulnerable. A recent preprint study, yet to undergo full peer review, discovered a correlation between the initial infection’s severity and the subsequent disease’s intensity. The study analyzed the electronic health records of more than 1.5 million COVID-19 patients treated in the US between March 2020 and July 2022. The data indicates that 6% of individuals experienced multiple infections, and the majority of reinfections coincided with the spread of the Omicron variant.

The data suggests that half of those hospitalized for the first time needed to be hospitalized again when reinfected. 90% of them had shown signs of a mild infection status and thus could avoid hospitalization when they were infected for the second time.

Reinfections also raised the risk of long COVID symptoms such as shortness of breath, tiredness, brain fog, and other symptoms. However, the basis for this still needs to be clarified. Some suggest biological factors could also be at play.

People With Lung Scarring At High Risk

doctor looking at chest x-ray of lungs with lung scarring

Pulmonologist Richard Boucher of the UNSC School of Medicine agrees that patients who had experienced widespread lung scarring would be at a higher risk of re-infection. The latest data also points to a glimmer of hope.

SARS-CoV-2 can be an issue as it settles in the lungs leading to systemic problems like shortness of breath, fever, and cough. The early variants invaded the lungs, but reports from Japan show that people who were fully vaccinated or were previously infected with the virus being reinfected by the Omicron subvariants cause symptoms in the nose and upper airways. The attack on the immune system leads to symptoms, resolved relatively sooner. So, even though being vaccinated does not prevent reinfection, it can help shield individuals from more severe outcomes, which as needing to be put on a ventilator.

Final Word

Vaccines are highly effective in reducing the intensity of the primary infection, and consequently, they are expected to mitigate the severity of any subsequent infections as well. However, many people are now being reinfected, and despite them being in the minority, those who suspect they have COVID should order a rapid PCR right away.

A Rapid PCR (at home covid test kit) helps those infected act quickly by isolating themselves, thus helping curb the spread of all variants in the wild.


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