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Observational Study
. 2023 Mar 21;18(3):e0280584.
doi: 10.1371/journal.pone.0280584. eCollection 2023.

Risk of and duration of protection from SARS-CoV-2 reinfection assessed with real-world data

Shannon L Reynolds  1 , Harvey W Kaufman  2 , William A Meyer 3rd  2 , Chris Bush  1 , Oren Cohen  3 , Kathy Cronin  4 , Carly Kabelac  1 , Sandy Leonard  5 , Steve Anderson  3 , Valentina Petkov  4 , Douglas Lowy  4 , Norman Sharpless  4 , Lynne Penberthy  4
Affiliations
Observational Study

Risk of and duration of protection from SARS-CoV-2 reinfection assessed with real-world data

Shannon L Reynolds et al. PLoS One. .

Abstract

This retrospective observational study aimed to gain a better understanding of the protective duration of prior SARS-CoV-2 infection against reinfection. The objectives were two-fold: to assess the durability of immunity to SARS-CoV-2 reinfection among initially unvaccinated individuals with previous SARS-CoV-2 infection, and to evaluate the crude SARS-CoV-2 reinfection rate and associated risk factors. During the pandemic era time period from February 29, 2020, through April 30, 2021, 144,678,382 individuals with SARS-CoV-2 molecular diagnostic or antibody test results were studied. Rates of reinfection among index-positive individuals were compared to rates of infection among index-negative individuals. Factors associated with reinfection were evaluated using multivariable logistic regression. For both objectives, the outcome was a subsequent positive molecular diagnostic test result. Consistent with prior findings, the risk of reinfection among index-positive individuals was 87% lower than the risk of infection among index-negative individuals. The duration of protection against reinfection was stable over the median 5 months and up to 1-year follow-up interval. Factors associated with an increased reinfection risk included older age, comorbid immunologic conditions, and living in congregate care settings; healthcare workers had a decreased reinfection risk. This large US population-based study suggests that infection induced immunity is durable for variants circulating pre-Delta predominance.

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Conflict of interest statement

Shannon L. Reynolds, Carly Kabelac, and Christopher Bush are employees of and own stock in Aetion, Inc. Harvey W. Kaufman and William A. Meyer III are employees of and own stock in Quest Diagnostics. Oren Cohen and Steve Anderson are employees of and own stock in Labcorp Drug Development. Steve Anderson has received consulting fees from Luminex. Sandy Leonard is an employee of and owns stock in HealthVerity. Douglas Lowry has received royalty-related payments from NIH. Kathy Cronin, Valentina Petkov, Norman Sharpless, and Lynne Penberthy report no conflict of interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Study population.
Fig 2
Fig 2. Cumulative incidence of SARS-CoV-2 infection from April 30th, 2020 through April 30th, 2021 among SARS-CoV-2 index positive vs SARS-CoV-2 index negative individuals.
There were 71,921 individuals who indexed negative but had a subsequent positive test result within the following 60 days. Of the 27,070,023 index positive and negative individuals, within the first 60 days from index date, 7,501 died in an inpatient setting and 4,275,540 were disenrolled or had no additional claims or EHR activity resulting in 22,786,982 who started follow-up on day 61.
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Update of

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