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. 2021 Apr:193:113-115.
doi: 10.1016/j.puhe.2021.01.021. Epub 2021 Feb 12.

Predictors of severe symptomatic laboratory-confirmed SARS-CoV-2 reinfection

E Murillo-Zamora  1 , O Mendoza-Cano  2 , I Delgado-Enciso  3 , C M Hernandez-Suarez  4
Affiliations

Predictors of severe symptomatic laboratory-confirmed SARS-CoV-2 reinfection

E Murillo-Zamora et al. Public Health. 2021 Apr.

Abstract

Objective: The aim of the study was to evaluate factors predicting severe symptomatic laboratory-confirmed (via Reverse transcription polymerase chain reaction, RT-PCR polymerase chain reaction) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection.

Study design: This is a nationwide retrospective cohort study that was conducted in Mexico.

Methods: Data from 258 reinfection cases (at least 28 days between both episodes onset) were analyzed. We used risk ratios (RRs) and 95% confidence intervals (CIs) to evaluate predictors of severe (dyspnea requiring hospital admission) secondary SARS-CoV-2 infection.

Results: The 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 (RRper 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 coronavirus disease 2019 (RR = 1.20, 95% CI = 1.03-1.39).

Conclusions: To 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 were 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.

Keywords: COVID-19; Cohort studies; Prognosis; Reverse transcription polymerase chain reaction; Severe acute respiratory syndrome coronavirus 2.

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Comment in

  • Reinfections with SARS-CoV-2 or second COVID-19 episodes?
    Cabrera-Gaytán DA, Santiago-Espinosa O, Prieto Torres ME. Cabrera-Gaytán DA, et al. Public Health. 2021 Sep;198:e17. doi: 10.1016/j.puhe.2021.05.018. Epub 2021 May 21. Public Health. 2021. PMID: 34172305 Free PMC article. No abstract available.

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