Abstract
With repeated positivity being an undiscovered and major concern, we aimed to evaluate which prognostic factors may impact repeated SARS-CoV-2 positivity (RSP) and their association with immunoglobulin detectability among recovered patients. A systematic literature search was performed on 5 April 2021. Cohort studies with risk factors for repeated RSP or information about the immunoglobulin response (immunoglobulin M (IgM) and/or immunoglobulin G (IgG)) were included in this analysis. The main examined risk factors were severity of the initial infection, body mass index (BMI), length of hospitalization (LOH), age, and gender, for which we pooled mean differences and odds ratios (ORs). Thirty-four cohort studies (N = 9269) were included in our analysis. We found that increased RSP rate might be associated with IgG positivity; IgG presence was higher in RSP patients (OR: 1.72, CI: 0.87–3.41, p = 0.117). Among the examined risk factors, only mild initial disease course showed a significant association with RSP (OR: 0.3, CI: 0.14–0.67, p = 0.003). Age, male gender, BMI, LOH, and severity of the first episode do not seem to be linked with repeated positivity. However, further prospective follow-up studies focusing on this topic are required.
Highlights
A study found that recurring SARS-CoV-2 polymerase chain reaction (PCR) positivity might occur in 2.4% to 69.2% of the patients [2]
We are not yet aware of prognostic factors potentially influencing the recurrence of positive results of PCR. In this meta-analysis of cohort studies, we aimed to assess the prognostic factors for repeated SARS-CoV-2 positive episodes (RSPs) and the prognostic value of immunoglobulin positivity
We suggest the follow-up of COVID-19 convalescent patients in terms of antibody positivity to identify Immunoglobulin G (IgG) negative patients, as they might be more prone to repeated positivity
Summary
More than one year after the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the number of confirmed infections exceeds 100 million and it has caused over 2 million deaths [1,2]. Some viral infections can lead to life-long immunity, such as morbilli, mumps and rubella, with low antigenic variability [3]. A single first episode of coronavirus disease 2019 (COVID-19) might not prevent a recurrence, and previous reports and a meta-analysis stipulated the possibility of reinfection [4,5,6,7]. A study found that recurring SARS-CoV-2 polymerase chain reaction (PCR) positivity might occur in 2.4% to 69.2% of the patients [2]. Reinfection is not defined by an international consensus. Repeated PCR positivity might result from relapse of the
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