1
|
Chelly S, Jaziri S, Ammar A, Ezzi O, Douss N, Saffar S, Tritar M, Njah M, Mahjoub M. Safety and efficiency of COVID-19 vaccine in North Africa. Hum Vaccin Immunother 2024; 20:2306703. [PMID: 38304972 PMCID: PMC10841012 DOI: 10.1080/21645515.2024.2306703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
Background In the absence of a specific treatment for COVID-19, preventive measures have been implemented to control this pandemic and vaccination is one of them. However, it is crucial to verify the safety and efficiency of every vaccine. The aim was to determinate the predictive factors of side effects and reinfection after COVID-19 vaccine. Methods A cross-sectional study was conducted in February 2022 among Tunisians infected with COVID-19 between March 2020 and February 2022, using an online self-administered questionnaire. We conducted univariate and multivariate analyses using binary stepwise logistic regression. Results A total of 1541 was selected from 1911 individuals. Comorbidities affected a quarter of the population (22.3%). Before the initial infection, 39.3% had received full vaccination, and 8.7% had received partial vaccination. By February 2022, the majority (82.9%) had received at least two vaccine doses. The reinfection rate was 30.6%. All vaccines prior to the first infection was identified as a protective factor against reinfection. Inactivated virus vaccinations were less likely to induce adverse effects. Conclusion ach vaccine has its own set of advantages and disadvantages: mRNA-based vaccines had a higher incidence of side effects but all vaccines provided better protection against reinfection.
Collapse
Affiliation(s)
- Souhir Chelly
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Shayma Jaziri
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Asma Ammar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Olfa Ezzi
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Nour Douss
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Sonia Saffar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Marouen Tritar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Mansour Njah
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Mohamed Mahjoub
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| |
Collapse
|
2
|
Omoike E, Miceli A, Busen K, Kohrman A, Sharma M, Harrington P. Relative Risk of COVID-19 Reinfection by Demographic and Vaccination Factors During the Period March 2020-October 2022. J Community Health 2024; 49:339-342. [PMID: 37945780 DOI: 10.1007/s10900-023-01303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
The risk of reinfection has been difficult to quantify throughout the pandemic, making the case for COVID-19 vaccination and receipt of booster doses to the public difficult for the public health community. To address this question, Michigan statewide COVID-19 infection and vaccination data was utilized in this cross-sectional study to determine the risk of reinfection by vaccination status. Cases were divided into subgroups by vaccination status, and the risk of reinfection in the various vaccination categories was then calculated by dividing the cumulative incidence of reinfection in a vaccine category by the cumulative incidence of reinfection of those not in that category Within this population, the risk of becoming reinfected was 1.6 times higher for those who were unvaccinated than those who were vaccinated; those with a primary series saw a 27% reduced risk of reinfections compared to those without a primary series. Those with an additional booster dose had a modest improvement, with 35% reduced risk of reinfection when compared to the other groups combined. These results provide population level data to support current public health vaccination recommendations.
Collapse
Affiliation(s)
- Enaholo Omoike
- Michigan Department of Health and Human Services, Lansing, MI, USA.
| | - Andrea Miceli
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Katherine Busen
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | | | - Mohit Sharma
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | | |
Collapse
|
3
|
Chen Y, Zhu W, Han X, Chen M, Li X, Huang H, Zhang M, Wei R, Zhang H, Yang C, Zhang T. How does the SARS-CoV-2 reinfection rate change over time? The global evidence from systematic review and meta-analysis. BMC Infect Dis 2024; 24:339. [PMID: 38515023 PMCID: PMC10956270 DOI: 10.1186/s12879-024-09225-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND There is a significant increase in the number of SARS-CoV-2 reinfection reports in various countries. However, the trend of reinfection rate over time is not clear. METHODS We searched PubMed, Web of Science, Medline, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Wanfang for cohort studies, case-control studies, and cross-sectional studies up to March 16, 2023, to conduct a meta-analysis of global SARS-CoV-2 reinfection rate. Subgroup analyses were performed for age, country, study type, and study population, and time-varying reinfection rates of SARS-CoV-2 were estimated using meta-regression. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Joanna Briggs Institute critical appraisal tool. RESULT A total of 55 studies involving 111,846 cases of SARS-CoV-2 reinfection were included. The pooled SARS-CoV-2 reinfection rate was 0.94% (95% CI: 0.65 -1.35%). In the subgroup analyses, there were statistically significant differences in the pooled reinfection rates by reinfection variant, and study type (P < 0.05). Based on meta-regression, the reinfection rate fluctuated with time. CONCLUSION Meta-regression analysis found that the overall reinfection rate increased and then decreased over time, followed by a period of plateauing and then a trend of increasing and then decreasing, but the peak of the second wave of reinfection rate was lower than the first wave. SARS-CoV-2 is at risk of reinfection and the Omicron variant has a higher reinfection rate than other currently known variants. The results of this study could help guide public health measures and vaccination strategies in response to the Coronavirus Disease 2019 (COVID-19) pandemic.
Collapse
Affiliation(s)
- Ying Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wenhui Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xinyue Han
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Miaoshuang Chen
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Xin Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Haiping Huang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Mengyuan Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China
| | - Rongjie Wei
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China
| | - Huadong Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan Province, China.
| | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| |
Collapse
|
4
|
Ismail NF, Rahman AE, Kulkarni D, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Kyaw MH, Nair H. Incidence and outcome of SARS-CoV-2 reinfection in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2023; 13:06051. [PMID: 37994839 PMCID: PMC10667793 DOI: 10.7189/jogh.13.06051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Background With the emergence of new variants and sub-lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reinfections can significantly impact herd immunity, vaccination policies, and decisions on other public health measures. We conducted a systematic review and meta-analysis to synthesise the global evidence on SARS-CoV-2 reinfections in the pre-Omicron era. Methods We searched five global databases (MEDLINE, Embase, CINAHL Plus, Global Health, WHO COVID-19) on 12 May 2022 and 28 July 2023 and three Chinese databases (CNKI, Wanfang, CQvip) on 16 October 2022 for articles reporting incidence and outcomes of SARS-CoV-2 reinfection before the period of Omicron (B.1.1.529) predominance. We assessed risk of bias using Joanna Briggs Institute critical appraisal tools and conducted meta-analyses with random effects models to estimate the proportion of SARS-CoV-2 reinfection among initially infected cases and hospitalisation and mortality proportions among reinfected ones. Results We identified 7593 studies and extracted data from 64 included ones representing 21 countries. The proportion of SARS-CoV-2 reinfection was 1.16% (95% confidence interval (CI) = 1.01-1.33) based on 11 639 247 initially infected cases, with ≥45 days between the two infections. Healthcare providers (2.28%; 95% CI = 1.37-3.40) had a significantly higher risk of reinfection than the general population (1.00%; 95% CI = 0.81-1.20), while young adults aged 18 to 35 years (1.01%; 95% CI = 0.8-1.25) had a higher reinfection burden than other age groups (children <18 years old: 0.57%; 95% CI = 0.39-0.79, older adults aged 36-65 years old: 0.53%; 95% CI = 0.41-0.65, elderly >65 years old: 0.37%; 95% CI = 0.15-0.66). Among the reinfected cases, 8.12% (95% CI = 5.30-11.39) were hospitalised, 1.31% (95% CI = 0.29-2.83) were admitted to the intensive care unit, and 0.71% (95% CI = 0.02-2.01) died. Conclusions Our data suggest a relatively low risk of SARS-CoV-2 reinfection in the pre-Omicron era, but the risk of hospitalisation was relatively high among the reinfected cases. Considering the possibility of underdiagnosis, the reinfection burden may be underestimated. Registration PROSPERO: CRD42023449712.
Collapse
Affiliation(s)
- Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | - Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Fuyu Zhu
- School of Public Health, Nanjing Medical University, Jiangsu, China
| | - Xin Wang
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Jiangsu, China
| | | | - Amit Srivastava
- Pfizer, Vaccines, Emerging Markets
- Orbital Therapeutics, United States of America
| | | | | | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Jiangsu, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
5
|
Allahverdiyeva A, Ağaçfidan A, Dogan L, Önel M, Uysal HK, Medetalibeyoğlu A, Şenkal N, Alaskarov E, Meşe S. Evaluation of SARS-CoV-2-Positive Patients with Suspected Reinfection. Viruses 2023; 15:2222. [PMID: 38005899 PMCID: PMC10675471 DOI: 10.3390/v15112222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of this study was to investigate the reinfection rates and characteristics of SARS-CoV-2 in individuals with SARS-CoV-2 RNA present in their clinical specimens for COVID-19. Our data from the COVID-19 Laboratory of Istanbul University were analyzed for 27,240 cases between 27 March 2020 to 8 February 2022. Demographic characteristics, vaccination statuses, comorbidities, and laboratory findings were evaluated in cases with suspected reinfection, as determined by the presence of SARS-CoV-2 RNA at a rate of 0.3% in clinical specimens. When comparing laboratory values, leukocyte counts were lower in the second and third infections compared with the first infection (p = 0.035), and neutrophil counts were lower in the second infection (p = 0.009). Symptoms varied, with coughing being common in the first infection and malaise being common in subsequent infections. These results suggest that it is important to continue to monitor reinfection rates and develop strategies to prevent reinfection. Our results also suggest that clinicians should be aware of the possibility of reinfection and monitor patients for recurrent symptoms.
Collapse
Affiliation(s)
- Aytaj Allahverdiyeva
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
- Department of Medical Microbiology, Azerbaijan Medical University, Baku 370022, Azerbaijan
| | - Ali Ağaçfidan
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Lerzan Dogan
- Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey;
| | - Mustafa Önel
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Hayriye Kırkoyun Uysal
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| | - Alpay Medetalibeyoğlu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Naci Şenkal
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.M.); (N.Ş.)
| | - Elvin Alaskarov
- Department of Otorhinolaryngology, Istanbul Medipol University, Istanbul 34230, Turkey
| | - Sevim Meşe
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey; (A.A.); (M.Ö.); (H.K.U.)
| |
Collapse
|
6
|
Zhou S, Zhang D, Chang J, Xia Z, Li J, Ni M, Li H. Effect of SARS-CoV-2 infection on seizure, anxiety, and depression in 107 patients with epilepsy. Epilepsy Behav 2023; 145:109290. [PMID: 37406559 PMCID: PMC10267500 DOI: 10.1016/j.yebeh.2023.109290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE To study the effects of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) on epileptic seizures, anxiety, and depression in patients with epilepsy. METHODS Based on the inclusion and exclusion criteria, an ambispective cohort study was hereby conducted on patients with epilepsy infected with SARS-CoV-2 who visited the outpatient and ward of the Department of Neurology of Xinyang Central Hospital from December 2022 (when the domestic epidemic prevention and control policy was lifted) to February 2023. A face-to-face questionnaire survey involving factors including basic information, vaccination with inactivated COVID-19 vaccines, number of seizures within 2 months before and after SARS-CoV-2 infection, and scores of anxiety and depression was carried out. RESULTS A total of 107 patients with epilepsy satisfying the inclusion and exclusion criteria completed the follow-up after 2 months. It was found that enrolled patients maintained the original dose of antiepileptic drugs, but the frequency of seizures after COVID-19 infection could not be controlled. After infection with SARS-CoV-2, the frequency of seizures in patients with epilepsy in 2 months increased compared with that before infection (P < 0.05). Meanwhile, compared with the vaccinated group, the high-frequency seizure rate of epilepsy in the unvaccinated group was higher. (P < 0.05), and the anxiety and depression scores of patients with epilepsy were worse than those before they were infected (P < 0.05). CONCLUSION Being infected with SARS-CoV-2 can increase the number of seizures and aggravate the degree of anxiety and depression in patients with epilepsy. The inactivated vaccine is protective, and the inactivated SARS-CoV-2 vaccine can reduce the rate of high-frequency seizures.
Collapse
Affiliation(s)
- Sichao Zhou
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Dexin Zhang
- Department of General ICU,Xinyang Central Hospital ,Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000, Henan, China
| | - Jianjun Chang
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Zhilun Xia
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Jing Li
- Department of Emergency Xinyang Central Hospital, Xinyang 464000, Henan, China
| | - Menghan Ni
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China
| | - Hao Li
- Department of Neurology Ward 1, Xinyang Central Hospital, National Secondary Epilepsy Center, Xinyang 464000, Henan, China.
| |
Collapse
|
7
|
Deng J, Ma Y, Liu Q, Du M, Liu M, Liu J. Severity and Outcomes of SARS-CoV-2 Reinfection Compared with Primary Infection: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3335. [PMID: 36834029 PMCID: PMC9961977 DOI: 10.3390/ijerph20043335] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 06/01/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection has brought new challenges to the global prevention and control of coronavirus disease 2019 (COVID-19) pandemic; however, current studies suggest that there is still great uncertainty about the risk of severe COVID-19 and poor outcomes after SARS-CoV-2 reinfection. Random-effects inverse-variance models were used to evaluate the pooled prevalence (PP) and its 95% confidence interval (CI) of severity, outcomes and symptoms of reinfection. Random-effects were used to estimate the pooled odds ratios (OR) and its 95%CI of severity and outcomes between reinfections and primary infections. Nineteen studies involving a total of 34,375 cases of SARS-CoV-2 reinfection and 5,264,720 cases of SARS-CoV-2 primary infection were included in this meta-analysis. Among those SARS-CoV-2 reinfection cases, 41.77% (95%CI, 19.23-64.31%) were asymptomatic, and 51.83% (95%CI, 23.90-79.76%) were symptomatic, only 0.58% (95%CI, 0.031-1.14%) manifested as severe illness, and 0.04% (95%CI, 0.009-0.078%) manifested as critical illness. The PPs for SARS-CoV-2 reinfection-related hospitalization, admission to ICU, and death were, respectively, 15.48% (95%CI, 11.98-18.97%), 3.58% (95%CI, 0.39-6.77%), 2.96% (95%CI, 1.25-4.67%). Compared with SARS-CoV-2 primary infection cases, reinfection cases were more likely to present with mild illness (OR = 7.01, 95%CI, 5.83-8.44), and the risk of severe illness was reduced by 86% (OR = 0.14, 95%CI, 0.11-0.16). Primary infection provided some protection against reinfection and reduces the risk of symptomatic infection and severe illness. Reinfection did not contribute to extra risk of hospitalization, ICU, or death. It is suggested to scientifically understand the risk of reinfection of SARS-CoV-2, strengthen public health education, maintain healthy habits, and reduce the risk of reinfection.
Collapse
Affiliation(s)
- Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Qiao Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
- Institute for Global Health and Development, Peking University, Beijing 100871, China
| |
Collapse
|
8
|
Flacco ME, Acuti Martellucci C, Baccolini V, De Vito C, Renzi E, Villari P, Manzoli L. Risk of reinfection and disease after SARS-CoV-2 primary infection: Meta-analysis. Eur J Clin Invest 2022; 52:e13845. [PMID: 35904405 PMCID: PMC9353414 DOI: 10.1111/eci.13845] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/09/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A precise estimate of the frequency and severity of SARS-CoV-2 reinfections would be critical to optimize restriction and vaccination policies for the hundreds of millions previously infected subjects. We performed a meta-analysis to evaluate the risk of reinfection and COVID-19 following primary infection. METHODS We searched MedLine, Scopus and preprint repositories for cohort studies evaluating the onset of new infections among baseline SARS-CoV-2-positive subjects. Random-effect meta-analyses of proportions were stratified by gender, exposure risk, vaccination status, viral strain, time between episodes, and reinfection definition. RESULTS Ninety-one studies, enrolling 15,034,624 subjects, were included. Overall, 158,478 reinfections were recorded, corresponding to a pooled rate of 0.97% (95% CI: 0.71%-1.27%), with no substantial differences by definition criteria, exposure risk or gender. Reinfection rates were still 0.66% after ≥12 months from first infection, and the risk was substantially lower among vaccinated subjects (0.32% vs. 0.74% for unvaccinated individuals). During the first 3 months of Omicron wave, the reinfection rates reached 3.31%. Overall rates of severe/lethal COVID-19 were very low (2-7 per 10,000 subjects according to definition criteria) and were not affected by strain predominance. CONCLUSIONS A strong natural immunity follows the primary infection and may last for more than one year, suggesting that the risk and health care needs of recovered subjects might be limited. Although the reinfection rates considerably increased during the Omicron wave, the risk of a secondary severe or lethal disease remained very low. The risk-benefit profile of multiple vaccine doses for this subset of population needs to be carefully evaluated.
Collapse
Affiliation(s)
- Maria Elena Flacco
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | | | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Erika Renzi
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Lamberto Manzoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|