Cargando…

Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity

BACKGROUND: Studies comparing SARS-CoV-2 reinfection outcomes among individuals with previous infection (natural immunity) and previous infection plus vaccination (hybrid immunity) are limited. METHODS: Retrospective cohort study comparing SARS-CoV-2 reinfection among patients with hybrid immunity (...

Descripción completa

Detalles Bibliográficos
Autores principales: Suleyman, Geehan, Fadel, Raef, Patel, Kunj, Shadid, Al Muthanna, Stuart, Haim Bernardo Cotlear, Kattula, Michael, Janis, Andrea, Maki, Mohamed, Chao, Shing, Alangaden, George, Brar, Indira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247297/
https://www.ncbi.nlm.nih.gov/pubmed/37302273
http://dx.doi.org/10.1016/j.jiph.2023.06.003
_version_ 1785055169235386368
author Suleyman, Geehan
Fadel, Raef
Patel, Kunj
Shadid, Al Muthanna
Stuart, Haim Bernardo Cotlear
Kattula, Michael
Janis, Andrea
Maki, Mohamed
Chao, Shing
Alangaden, George
Brar, Indira
author_facet Suleyman, Geehan
Fadel, Raef
Patel, Kunj
Shadid, Al Muthanna
Stuart, Haim Bernardo Cotlear
Kattula, Michael
Janis, Andrea
Maki, Mohamed
Chao, Shing
Alangaden, George
Brar, Indira
author_sort Suleyman, Geehan
collection PubMed
description BACKGROUND: Studies comparing SARS-CoV-2 reinfection outcomes among individuals with previous infection (natural immunity) and previous infection plus vaccination (hybrid immunity) are limited. METHODS: Retrospective cohort study comparing SARS-CoV-2 reinfection among patients with hybrid immunity (cases) and natural immunity (controls) from March 2020 to February 2022. Reinfection was defined as positive PCR > 90 days after initial laboratory-confirmed SARS-CoV-2 infection. Outcomes included time to reinfection, symptom severity, COVID-19-related hospitalization, critical COVID-19 illness (need for intensive care unit, invasive mechanical ventilation, or death), length of stay (LOS). RESULTS: A total of 773 (42%) vaccinated and 1073 (58%) unvaccinated patients with reinfection were included. Most patients (62.7%) were asymptomatic. Median time to reinfection was longer with hybrid immunity (391 [311−440] vs 294 [229−406] days, p < 0.001). Cases were less likely to be symptomatic (34.1% vs 39.6%, p = 0.001) or develop critical COVID-19 (2.3% vs 4.3%, p = 0.023). However, there was no significant difference in rates of COVID-19-related hospitalization (2.6% vs 3.8%, p = 0.142) or LOS (5 [2–9] vs 5 [3–10] days, p = 0.446). Boosted patients had longer time to reinfection (439 [IQR 372–467] vs 324 [IQR 256–414] days, p < 0.001) and were less likely to be symptomatic (26.8% vs 38%, p = 0.002) compared to unboosted patients. Rates of hospitalization, progression to critical illness and LOS were not significantly different between the two groups. CONCLUSIONS: Natural and hybrid immunity provided protection against SARS-CoV-2 reinfection and hospitalization. However, hybrid immunity conferred stronger protection against symptomatic disease and progression to critical illness and was associated with longer time to reinfection. The stronger protection conferred by hybrid immunity against severe outcomes due to COVID-19 should be emphasized with the public to further the vaccination effort, especially in high-risk individuals.
format Online
Article
Text
id pubmed-10247297
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.
record_format MEDLINE/PubMed
spelling pubmed-102472972023-06-08 Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity Suleyman, Geehan Fadel, Raef Patel, Kunj Shadid, Al Muthanna Stuart, Haim Bernardo Cotlear Kattula, Michael Janis, Andrea Maki, Mohamed Chao, Shing Alangaden, George Brar, Indira J Infect Public Health Article BACKGROUND: Studies comparing SARS-CoV-2 reinfection outcomes among individuals with previous infection (natural immunity) and previous infection plus vaccination (hybrid immunity) are limited. METHODS: Retrospective cohort study comparing SARS-CoV-2 reinfection among patients with hybrid immunity (cases) and natural immunity (controls) from March 2020 to February 2022. Reinfection was defined as positive PCR > 90 days after initial laboratory-confirmed SARS-CoV-2 infection. Outcomes included time to reinfection, symptom severity, COVID-19-related hospitalization, critical COVID-19 illness (need for intensive care unit, invasive mechanical ventilation, or death), length of stay (LOS). RESULTS: A total of 773 (42%) vaccinated and 1073 (58%) unvaccinated patients with reinfection were included. Most patients (62.7%) were asymptomatic. Median time to reinfection was longer with hybrid immunity (391 [311−440] vs 294 [229−406] days, p < 0.001). Cases were less likely to be symptomatic (34.1% vs 39.6%, p = 0.001) or develop critical COVID-19 (2.3% vs 4.3%, p = 0.023). However, there was no significant difference in rates of COVID-19-related hospitalization (2.6% vs 3.8%, p = 0.142) or LOS (5 [2–9] vs 5 [3–10] days, p = 0.446). Boosted patients had longer time to reinfection (439 [IQR 372–467] vs 324 [IQR 256–414] days, p < 0.001) and were less likely to be symptomatic (26.8% vs 38%, p = 0.002) compared to unboosted patients. Rates of hospitalization, progression to critical illness and LOS were not significantly different between the two groups. CONCLUSIONS: Natural and hybrid immunity provided protection against SARS-CoV-2 reinfection and hospitalization. However, hybrid immunity conferred stronger protection against symptomatic disease and progression to critical illness and was associated with longer time to reinfection. The stronger protection conferred by hybrid immunity against severe outcomes due to COVID-19 should be emphasized with the public to further the vaccination effort, especially in high-risk individuals. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. 2023-08 2023-06-08 /pmc/articles/PMC10247297/ /pubmed/37302273 http://dx.doi.org/10.1016/j.jiph.2023.06.003 Text en © 2023 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Suleyman, Geehan
Fadel, Raef
Patel, Kunj
Shadid, Al Muthanna
Stuart, Haim Bernardo Cotlear
Kattula, Michael
Janis, Andrea
Maki, Mohamed
Chao, Shing
Alangaden, George
Brar, Indira
Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title_full Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title_fullStr Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title_full_unstemmed Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title_short Outcomes associated with SARS-CoV-2 reinfection in individuals with natural and hybrid immunity
title_sort outcomes associated with sars-cov-2 reinfection in individuals with natural and hybrid immunity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247297/
https://www.ncbi.nlm.nih.gov/pubmed/37302273
http://dx.doi.org/10.1016/j.jiph.2023.06.003
work_keys_str_mv AT suleymangeehan outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT fadelraef outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT patelkunj outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT shadidalmuthanna outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT stuarthaimbernardocotlear outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT kattulamichael outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT janisandrea outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT makimohamed outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT chaoshing outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT alangadengeorge outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity
AT brarindira outcomesassociatedwithsarscov2reinfectioninindividualswithnaturalandhybridimmunity