COVID-19 Reinfection Research Articles

Fear and Stigma of COVID-19 Reinfection Scale (FSoCOVID-19RS): New Scale Development and Validation.

The advent of COVID-19 and its impacts have prompted fear and stigma among people all across the world. Because of stigma, there was often a delay in diagnosis and treatment, which resulted in a poor prognosis. As a result, a reliable scale is required to measure the level of fear and stigma of COVID-19 reinfection. To develop and validate a scale for determining the level of fear and stigma of COVID-19 reinfection. A cross-sectional study including 200 nursing-college students who had previously tested positive for COVID-19 was conducted. The scale's reliability was evaluated by external and internal consistency methods. Construct, convergent, and discriminant validity were evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The scale's mean score was 24.85 ± 11.35, and no floor or ceiling effects were detected. The scale items' reliability, measured by Cronbach's alpha coefficient if an item was deleted, ranged from 0.76 to 0.95, with a total score value of 0.86. The range of convergent validity coefficients was between 0.37 and 0.64. Pearson's correlation coefficients for test-retest validity ranged from 0.71 to 0.93, with a total score of 0.82. The coefficient of split-half correlation was 0.87, while the coefficient of reliability was 0.93. According to the factor analysis, two components had latent roots larger than 1. The rotated component matrix of the two factors revealed that all items had R values over 0.30, indicating that none of them should be excluded. In addition, CFA results revealed that χ2 = 3524, df = 1283, χ2/df ratio = 2.74, p < 0.001, GFI = 0.86, CFI = 0.92, AGFI = 0.88, and RMSEA = 0.05. The scale's convergent and discriminant validity was confirmed. The 14-item, two-dimensional Fear and Stigma of COVID-19 Reinfection Scale (FSoCOVID-19 RS) was demonstrated to have reliable psychometric properties.

COVID‐19 disease frequency, risk factors, and re‐infection rates in patients with autoimmune rheumatic disease receiving rituximab

Rituximab, which is used in autoimmune rheumatic diseases (ARD), can cause both an increased risk of development of COVID-19 disease and re-infection due to its potent and long-acting immunosuppression. So, we aimed to evaluate the frequency, risk factors and re-infection rates of COVID-19 in ARD patients receiving rituximab. A single-center retrospective study was performed with patients receiving rituximab for ARD in 12 months before the onset of COVID-19 in Turkey. The data regarding severe acute respiratory syndrome-coronavirus 2 reverse transcription polymerized chain reaction (RT-PCR) test, clinical, laboratory, and mortality data of all patients were collected from medical records. Logistic regression analysis was used for predictors of COVID-19 disease. COVID-19 re-infection was defined as RT-PCR positivity and recurrence of acute COVID-19 symptoms after at least 1 negative RT-PCR in patients with clinical improvement. Ninety-eight ARD patients with rituximab were evaluated and 23 (23%) of them had COVID-19. The presence of hypogammaglobulinemia increased the risk of COVID-19 disease 8-fold. COVID-19 pneumonia occurred in 13 (57%) and these patients' age was higher than those without pneumonia (59.6 ± 11.8 vs 44.9 ± 14.2 years, P=0.013). Mortality due to COVID-19 was 13% and COVID-19 re-infection was seen in 20% of survivors. Regardless of the underlying rheumatic disease and organ involvements, hypogammaglobulinemia in ARD could be a risk factor for COVID-19 development, and advanced age could be for COVID-19 severity. Moreover, COVID-19 re-infection rates are high.

Exosomes in COVID‐19 infection: Focus on role in diagnosis, pathogenesis, immunity, and clinical trials

Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread as a new strain of coronavirus disease (COVID-19) and progressed as a global pandemic. Exosomes are membrane-bound vesicles released from almost all cells and are crucially involved in cell-cell communication. Interestingly, COVID-19 viral particles produce exosomes that moderate communication between infected and uninfected cells. Hence, there is growing evidence highlighting the crucial implications of exosomes in COVID-19 infection, transmission, intercellular spread, and reinfection. On the other hand, clinical trials have demonstrated mesenchymal stem cell-derived exosomes as a promising therapeutic strategy for severely affected COVID-19 patients. Also, convalescent plasma-derived exosomes have been proposed for multiple efficacies in COVID-19 patients. Furthermore, messenger RNAs (mRNA)-loaded exosomes were superior to mRNA-loaded lipid nanoparticles as a delivery system. Hence, exosomes can be used to safely induce SARS-CoV-2 immunity via their loading with mRNAs encoding immunogenic forms of SARS-CoV-2 spike and nucleocapsid proteins. Moreover, exosomes can be used as a nano-delivery system for microRNA to alleviate cytokine storm and prevent the progression of organ failure in COVID-19 patients. The present review summarizes state of the art concerning the role of exosomes in COVID-19 infection and accompanying organ complications as well as the potential use of exosomes in COVID-19 diagnosis, treatment, drug delivery, and vaccination. The review also sheds the light on the common biogenic pathway between the SARS-CoV-2 virus and exosomes. Additionally, the latest and current clinical trials using exosomes for COVID-19 infection are summarized.

Vocal Habilitation in Post-Acute Symptomatic COVID-19 Recovery: A Narrative Review of Strategies for Singing Teachers

The World Health Organisation declared a global health pandemic on March 11, 2020. Over two and a half years later, symptomatic COVID-19 infection and reinfection rates remain problematically high throughout the world. Singers, singing teachers, and other professional voice users affected by COVID-19 report significant vocal, respiratory, psychological, and stamina disturbances that impact their work. Mitigating recovery time is essential for the professional voice user. Limited research has been conducted on vocal health and production for singers affected by COVID-19. This narrative literature review aims to synthesise knowledge of symptoms that affect vocal health and production. Multidisciplinary literature from the vocology, speech pathology, otolaryngology, psychology, education, singing voice pedagogy, and voice science fields were comprehensively searched, screened, reviewed, and synthesised. Findings were used to frame practice-based strategies to support the vocal habilitation of singers recovering from symptomatic COVID-19. KEYWORDS: vocology, singing voice pedagogy, voice disorders, COVID-19

Asymptomatic COVID-19 Reinfection in a Pediatric Patient with Heterotaxy Syndrome.

We report an asymptomatic child with heterotaxy syndrome who had recurrent positive SARS-CoV-2 polymerase chain reaction testing. An aberrant lymphocyte population expressing CD19, CD16, and CD56 was identified; its phenotyping revealing atypical NK cells. This subset's role in protection from severe disease or in reinfection cannot be ascertained.

Results from a systematic programme of evaluating COVID-19 reinfection cases in the early phase of the pandemic, Singapore

ObjectivesThe objectives of this study were to describe the coronavirus disease caused by SARS-CoV-2 (COVID-19) reinfection evaluation algorithm used in the early phase of the pandemic in Singapore and analyze the clinical and laboratory characteristics of the cases evaluated.MethodsWe performed a retrospective case-control analysis including all COVID-19 cases evaluated for possible reinfection under the local COVID-19 reinfection evaluation programme between 1 June 2020-30 June 2021. Whole genome sequencing (WGS) was used as confirmatory testing. We compared all reinfection (“RI”) cases against those who were evaluated but eventually assessed not to be reinfection (“non-RI”).ResultsThere were 74 possible reinfection cases evaluated through the programme, of which 32 were subsequently classified as RI. There was strong statistical evidence that RI cases had a longer interval between 1st and 2nd episode (mean 297 days; 95%-confidence interval (CI) 267–327) compared to non-RI cases (mean 186 days; 95%-CI 144–228). The cycle threshold (Ct) value of initial polymerase chain rection (PCR) at 2nd episode was also found to be significantly lower in RI cases (mean 23; 95%-CI 20–26) compared to non-RI cases (mean 34; 95%-CI 32–36). There was no significant difference in the proportion of individuals who had fever, acute respiratory symptoms or asymptomatic in both groups. Delta and beta variants were most commonly identified from WGS and provide indication of re-infection as these were not ‘wild-type’ and were not circulating during the time period of the index infection.ConclusionsUsing a combination of serologic, microbiologic and genomic criteria to evaluate possible reinfection cases is useful and can provide a framework for evaluation that may be modified for future similar situations.

Time-related changes in the titer of virus neutralizing antibodies against SARS-CoV-2 after COVID-19 in patients with HIV infection

Objective. To assess the time-related changes in the titer of virus neutralizing antibodies to SARS-CoV-2 in patients with HIV infection within 6 months after experienced COVID-19, and to identify factors associated with the intensity and duration of the natural humoral immune response.Materials and Methods. А prospective study was performed in 102 HIV-infected patients who had COVID-19 without previous vaccination, the titer of virus neutralizing antibodies to SARS-CoV-2 was identified by microneutralization assay using the standard method, the follow-up period was 6 months. Patients were enrolled in St. Petersburg from October 2020 to January 2022. The possible impact of clinical and laboratory characteristics of HIV infection and the severity of COVID-19 on antibody titer was assessed.Results and discussion. А high antibody titer (&gt;1:160) was detected at 1 month in 15 patients (14.7%), at 3 months — in 5 of 44 patients; at 6 months — in 3 of 26 patients. There was a statistically significant positive correlation of the titer at 1 month with an undetectable HIV viral load and the Cd4+lymphocytes count in the blood. Cases of a late increase in antibody titer (after 3 and 6 months) were registered without COVID-19 re-infection along with improvement of the immune status on antiretroviral therapy.Conclusion. А low incidence of effective humoral immune response 1 month after COVID-19 infection was demonstrated in HIV-infected patients without vaccination against SARS-CoV-2. Single cases of delay in antibody titer increase with an immune status improvement were observed.

Rehospitalization Incidence in COVID-19 Reinfection: A Retrospective Cohort Study

Rehospitalization Incidence in COVID-19 Reinfection: A Retrospective Cohort Study

Interleukin-17 Inhibitor in Treatment of Psoriasis during COVID-19 Pandemic: An Ambispective Study

Introduction: Psoriasis is a genetically mediated chronic inflammatory disease that is frequently associated with metabolic co-morbidities. These metabolic co-morbidities have a huge impact in deciding the appropriate immunosupressant of choice in the current scenario of Coronavirus Disease (COVID19) pandemic. Treatment of psoriasis especially with biologicals is challenging during covid pandemic since immunosuppressive therapy might interfere with antiviral immunity. Aim: To report the safety profile of Interleukin-17 (IL-17) inhibitor, namely injection secukinumab in patients of psoriasis vulgaris during COVID-19 pandemic. Materials and Methods: An ambispective interventional study was performed on 23 patients of psoriasis who were administered secukinumab at a dose of 300 mg subcutaneously during COVID19 pandemic.The study was conducted at the Department of Dermatology, Madras Medical College, Chennai, Tamil Nadu, India among the patients attending the psoriasis clinic between the July 2021 to March 2022. The demographic characteristics of the study group, previous treatment for psoriasis and the relationship between risk of COVID-19 infection and secukinumab were noted. Efficacy of secukinumab was calculated using Psoriasis Area and Severity Index (PASI) scores. Statistical analysis was conducted with Statistical Package for Social Sciences (SPSS) statistics software version 21.0 by Fischer’s-exact test. Results: Out of 23 patients, 17 patients (11 males, six females) completed full course of nine doses (five weekly doses followed by four monthly doses) of secukinumab. The PASI 75 and PASI 90 were achieved in 9 (52.94%) and 8 (29.41%) patients respectively at the end of 12 weeks. None of the patients developed COVID-19 infection during the course of treatment and three months following therapy. Patients with psoriasis who had a history of COVID-19 infection did not show signs of reinfection when started on secukinumab. Both inactivated vaccine (Covaxin) and vector based vaccine (Covishield) were found to be safe in concomitant use with secukinumab. Conclusion: Secukinumab is found to be safe and effective in psoriasis treatment during COVID-19 pandemic. There is no increased risk of COVID-19 infection or reinfection, COVID-19 associated hospitalisation and mortality among patients with psoriasis administered with secukinumab. The drug can also be safely used with COVID-19 vaccines.

Maternal and neonatal outcomes of Covid-19 re-infection in pregnancy: a national observational study in israel

Maternal and neonatal outcomes of Covid-19 re-infection in pregnancy: a national observational study in israel

Impact of Vaccination on Symptomatology among COVID-19 Infection and Re-infection

Background: Present indications proposed strong bases that people suffered from SARS-CoV-2 infection are still susceptible to re-infection. Studies proposed that one of the COVID-19 viral vector vaccine and two genetic mRNA vaccines presented generous defense for COVID-19 infection as well as persisted effectively against mutated variants. Aim: To observe the impact of vaccination symptomatology among patients presented with COVID-19 infection for the first time and compared it with those of re-infected cases during 5th wave in Pakistan Methods: This descriptive study included a total of 248 patients were interviewed using a semi-structured questionnaire. Patients themselves or their attendants receiving reports from the counter of various laboratories were targeted. A verbal informed consent was taken before data collection. Following information about, job nature, side effects after vaccination, comorbidities, level of symptoms (i.e. mild, moderate and high) Results: A total 248 patients consisting of 52.0% females and 48.0% males with overall mean age of 35.96±17.94 years. A total of 37.5% patients were re-infected further proportion of male gender 46.2% and 29.5% were females. Proportion of re-infection in fully vaccinated group remained to be 35.5%, partially vaccinated as 43.9% and unvaccinated as 42.9%. ANOVA was applied to compare the severity of symptoms with full, partial and unvaccinated patients. Conclusion: Lack of discernable variations in protection against COVID-19 re-infection were observe through vaccination or prior infection. Ultimately trends show an enhancement in level of protection from re-infection was shown as prior infection alone, partial vaccination and full vaccination respectively. Keywords: COVID-19, SARS-CoV-2, re-infection, Symptomatology.

1878. Demographic and Clinical Characteristics of COVID-19 Reinfection

Abstract Background COVID-19 reinfection is generally defined as having 2 positive SARS-CoV-2 tests greater than 90 days apart. The clinical implications and impact of COVID-19 reinfection are not completely understood. We evaluated clinical and demographic characteristics of patients with COVID-19 reinfection. Methods All SARS-CoV-2 polymerase chain reaction (PCR) tests performed at Joint Base San Antonio (JBSA), from March 27, 2020 through January 19, 2022 were analyzed. COVID-19 reinfection was defined as having 2 positive PCR tests &amp;gt;90 days apart. Available data for comorbidities, travel, COVID-19 vaccination status, SARS-CoV-2 genotype, symptoms, hospitalization, and treatments were compared for first and second infections. Results A total of 310,704 SARS-CoV-2 PCR tests performed of which 25,543 (8.2%) were positive at JBSA during the study period. Patients with COVID-19 reinfection (n=532; 4.2%) were identified and 266 (50%) charts reviewed. The mean age was 36.5 (±15) years and approximately half were males and active duty members (Table 1). The median time from first to second infection was 326 days (IQR 160-385). Patients were predominantly unvaccinated (91.4%) at initial infection, however unvaccinated status was less common (40.2%) at second infection (40.2%; P&amp;lt; 0.0001). A significantly higher proportion of patients were symptomatic at first infection (88.3%) compared to second infection (51.5%; P&amp;lt; 0.001). Pneumonia diagnosis was significantly higher (4.9% vs. 0.4%; P=0.0011) whereas hospitalization was similar (2.6% vs. 2.3%; P=0.0788) for first compared to second infection. Among hospitalized patients, critical illness was common for first infection (57.1%) but none of the patients were critically ill with their second infection. A third episode of infection was rarely observed (1.5%). Of 80 genotype samples available, 14 (30%) were paired samples. Among all paired samples different genotypes were responsible for reinfection (Table 2). Conclusion Patients with COVID-19 reinfections were less likely to be symptomatic, had lower severity of illness, and typically had a different SARS-CoV-2 genotype at second infection. Reinfection occurred despite COVID-19 vaccination in many patients, which highlights the need to develop novel strategies for vaccination. Disclosures All Authors: No reported disclosures.

1892. Rise of COVID-19 Re-infections as Omicron Variant Prevailed: Implications on Monitoring the Course of the Pandemic

Abstract Background The emergence of the highly infectious Omicron variant at the end of 2021 changed the pandemic dynamics, also causing an increase in COVID-19 re-infections. Our aim was to investigate suspected re-infections and the characteristics of individuals with multiple infections since the beginning of the pandemic until early April 2022. Methods Since the beginning of the pandemic, all COVID-19 positive tests (Rapid Antigen Tests - RAT and PCR) have been recorded in the COVID-19 National Electronic Registry. Cases were extracted and reported daily based on the first positive test for each individual (first episodes). Establishment of the Omicron variant, associated with a re-infection surge, triggered the decision for modifying case definition and applying a different methodology to include suspected re-infections in the number of daily reported cases after 3rd of April. Suspected re-infections were defined as “positive PCR or RAT sample ≥90 days following a previous positive PCR or RAT”. The number of re-infections were estimated retrospectively on the Registry’s data. Results Overall, 6,348 suspected re-infections were recorded up to 15/12/2021 (0.6% of the laboratory confirmed tests), whereas until 3/4/22 the number was increased at 115.201, raising the percentage to 4%. Distribution of the number of reinfections per ISO week is depicted in Figure 1, along with the number of first episodes. Suspected re-infections stand for 3.7% of the total number of first episodes recorded up to 3/4/22 (3,077,711), with their integration having a noticeable effect on case counting. Among them, 99.3% represent a second episode of infection and 0.7% multiple re-infections. Median age of suspected re-infections was 29 years (IQR: 19-44) (Figure 2). The median length of the time interval between two subsequent infections was 8 months (IQR: 5-12) (Figure 3). Conclusion Up until mid-December 2021, COVID-19 re-infection was uncommon, changing to higher rates after the emergence of Omicron variant, thus documenting the immune escape capacity of this variant. Besides the improvement in surveillance, knowledge about the re-infections and their characteristics provides a proxy of the immune protection from previous exposure to COVID-19, against circulating variants over time. Disclosures All Authors: No reported disclosures.

1867. Characteristics and Outcomes of Patients with SARS-CoV-2 Reinfections Requiring Treatment in a COVID-19 Ambulatory Treatment Program

Abstract Background Montefiore Medical Center (MMC), Bronx, NY, established an ambulatory program to offer COVID-19 treatments (monoclonal antibodies [mAB] and oral antivirals) to patients with mild-moderate illness according to emergency use authorization criteria. Given multiple pandemic waves in the area, several patients have been reinfected and were treated twice. The objective of this analysis is to identify clinical characteristics and outcomes in patients with repeated COVID-19 infections and treatments. Methods Electronic health records were reviewed to identify patients between December 1, 2020 and April 28, 2022 who received COVID-19 treatment on more than one occasion at MMC. Data collected included demographics, risk factors for progression to severe illness, name and date of COVID-19 treatments received, vaccination status, and clinical outcomes of 30-day emergency department (ED) presentation or hospital admission following each treatment. Results Out of 3,042 total treated patients, 13 (0.4%) received multiple treatments with either mAB or oral antivirals for COVID-19 reinfection during the study period. Median age of reinfected patients requiring treatment was 50 years. Median days between first and second treatments was 298 days (range 91-468 days). The most common risk factor for progression to severe disease were cardiovascular disease (54%) and immunocompromised status (62%) (Table 1). Ten patients had received at least two doses of vaccine (77%) with Pfizer (54%) or Moderna (23%) vaccines prior to reinfection. No patients reported any adverse reactions to either treatment. Four patients presented to the ED or were hospitalized following treatment of reinfection, three of which were for COVID-related symptoms. Of these, two had two risk factors for progression and the third had been hospitalized previously for initial COVID-19 infection. Conclusion Though COVID-19 reinfection has been described, especially during Omicron surges, there were relatively few reinfected patients requiring treatment in our cohort. Patients with risk factors for disease progression may also be at increased risk for reinfection, especially the immunocompromised. Disclosures Kelsie Cowman, MPH, Merck: Grant/Research Support Yi Guo, PharmD, BCIDP, Merck: Grant/Research Support.

Efficacy and Short-Term Safety of COVID-19 Vaccines: A Cross-Sectional Study on Vaccinated People in the UAE.

The emergence of COVID-19 has been a major challenge to public health and the world economy. During a wave of COVID-19, the usage of widespread vaccination procedures and broader coverage to the whole of humanity will be made possible if the general population has access. An intended effect of vaccination is to provide "herd immunity," which protects those who have not been vaccinated along with those who have been. However, some concerns regarding the safety and efficacy of COVID-19 vaccines were raised. This study aims to provide evidence on the short-term safety and efficacy of four types of vaccines that are officially approved by the Ministry of Health in the United Arab Emirates (UAE). These include Sinopharm, Sputnik V, Pfizer, and AstraZeneca. This study utilized a cross-sectional descriptive design. Data on the efficacy and short-term protection of COVID-19 vaccines on vaccinated citizens and residents (n = 764) of the UAE were collected between February and April 2021. Participants were conveniently approached using a Google Forms survey, where they responded to a semi-structured questionnaire pertaining to socio-demographic questions and in-depth questions related to COVID-19, including whether they suffer from any comorbidities, the most commonly encountered post-vaccination side effects, and the severity of their symptoms, using a 5-point Likert scale. Results were analyzed using SPSS version 24, calculations of p-values and descriptive statistics were used for data differentiation. The majority of the participants (n = 612 or 94.4%) stated that they did not become reinfected after receiving two doses of COVID-19 vaccine. In addition, the incidence of being hospitalized after vaccination was negligible. In terms of adverse effects, the most common individually reported side effects, regardless of the vaccination type, included "pain at the site of injection", followed by "general fatigue", then "lethargy". Moreover, most of these side effects occurred after the second dose of the vaccine, irrespective of the type of vaccine. Females were found to be more susceptible to the adversities of COVID-19 vaccination. The occurrence of side effects was not found to be related to the nationality/ethnicity of the vaccine recipient. Furthermore, none of the vaccines affected sleep pattern, since a significant number of respondents reported a regular sleep pattern after being vaccinated. The majority respondents who received two doses of vaccination (n = 585 or 76.6%) reported that they did not become infected post vaccination, regardless the type of vaccine received, whereas only (n = 11 or 1.9%) were reinfected with COVID-19 after 2-4 weeks. The findings of this study suggest that vaccines can offer short-term protection against COVID-19 reinfection. Moreover, both the first- and second-vaccination side effects were described as very mild to moderate, which indicates tolerability. These data may strengthen the public confidence in receiving vaccinations.

1876. COVID-19 Reinfection and Disease Severity in the New York City Health + Hospitals System

Abstract Background Though reinfection with SARS-CoV-2 is well documented, there remains uncertainty about the potential for more severe symptoms with reinfections compared to index infections. Methods Patients who received SARS-CoV-2 PCR testing between March 1, 2020 and March 1, 2021 at New York City Health and Hospitals (NYC H+H) facilities and had two positive tests &amp;gt; =90 days apart were included in the analysis. Clinical and demographic data were extracted from the electronic medical record. Manual chart review was done to confirm symptomatology, assess COVID-19 related hospital admissions, and determine WHO disease severity. Patients were then classified as unlikely reinfection, possible reinfection, or probable reinfection based on symptomatology, PCR and antibody testing, and lack of alternative diagnoses. Patients were classified as “unable to be assessed” if symptomatology could not be assessed for both episodes of PCR positivity. Figure 1:Flow chart of selection process for study inclusionFigure 2:Reinfection Classification Results During our study timeframe, 1,255,584 unique patients received at least one SARS-CoV-2 PCR test, 265 of whom had two positive tests &amp;gt; =90 days apart. We categorized 20 patients as unable to be assessed, 28 as unlikely reinfection (1 persistent PCR positivity, 27 unlikely true infection at index or second PCR-positive episode), and 217 as possible or probable reinfection. Of the 217, at their index episode 79 had an asymptomatic infection (36.4%) and 17 were severe or critical (7.8%). At their second episode, 162 patients had an asymptomatic infection (74.7%), and 5 were severe or critical (2.3%). Only 24 patients with possible/probable reinfection had a more severe COVID reinfection than index infection, and 20 of the 24 had asymptomatic index infections. Three patients were hospitalized at both episodes, and two deaths possibly attributable to COVID-19 reinfection were noted in this cohort. Figure 3:Change in WHO disease severity classification from index to second infection among probable/possible reinfection cases (n=217) Red indicates increase in disease severity from index to reinfection (n=24), blue indicates decrease in disease severity from index to reinfection (n=100), white indicates no change (n=74) and gray indicates unable to assess disease severity at index or second infection (n=19). Conclusion COVID-19 reinfection was rare in a high incidence setting among patients tested at NYC H+H facilities. Disease severity was generally milder in reinfection, although severe and critical disease occurred in a small number of patients. These findings from earlier in the pandemic (presumably wild-type and alpha variant) provide data for comparison in understanding how reinfection is evolving with newer variants. Disclosures Carlos Salama, MD, Genentech: Advisor/Consultant Gabriel Cohen, MD, Daybreak Health: Advisor/Consultant|Daybreak Health: Board Member|Daybreak Health: Ownership Interest.

Long-term Consequences, Chances of Re-infection, and Outcomes among Cases Recovered with Severe COVID-19 at a Tertiary Care Centre in Central India

COVID-19 has a wide disease spectrum. Different presentations may be seen in different people, with uncertain long-term fate. The amount and longevity of immunity provided among the infected also vary from person to person which might in turn affect the chances of re-infection. Current study tries to uncover the incidence, disease severity and outcomes amongst those who have been previously hospitalized for COVID-19. A prospective cohort study where all patients admitted to intensive care facility at the tertiary care center were followed up for any occurrences of re-infection for more than one year. All cases were followed up telephonically and at scheduled visits to the hospital by trained personnel. A total of 410 cases with a mean age of 59.8 years, including 310 (75.6%) males and 100 (24.4%) females. Among these 410 patients 287 remained alive till the end of study period. Re-infection rates among recovered ICU admitted seriously ill patients were 1.4% whereas the rate of ICU re-admission due to COVID-19 re-infection was only 0.7%. Re-infection among female was 1.1% whereas in male was 1.5%. ICU readmission rate among female was 1.1% while in male was 0.5% only. The chances of re-infection in female were seen less than that in males, but the severity of re-infection in females was found to be higher. COVID-19 re-infection in previously severely infected COVID-19 patient is not so common. The chances of a severe disease among such cases are even rarer.

Recurrence of COVID-19 Infection in Healthcare Workers after complete Vaccination

Background: COVID-19 is a novel infection. Since its first case report in 2019, it has affected population globally. Healthcare workers are at most risk as they are in direct contact with patients. Aim: To record recurrence of symptomatic COVID 19 after complete doses of Sinopharm vaccine among healthcare workers. Study design: Descriptive case series Place and duration of study: Department of Gastroenterology, Holy Family Hospital, Rawalpindi from 12th December 2021 to 11th June 2022. Methodology: Twenty four healthcare workers and between 20-60 years who had COVID-19 infection previously and despite receiving two doses of Sinopharm vaccine, again developed symptomatic COVID-19 diseases were enrolled. The severity was graded as per guidelines provided by CEAG. The extent of exposure during work was documented. Results: No significant association was found with any of the healthcare workers with duration and extent of vaccination. Upto 66% of the front line workers got COVID at 5th month and no considerable variation was noticed in other months of the vaccination. Similarly, three PGs also got COVID at 5th month and at 5th month highest number of frontline workers got COVID-19. Conclusion: COVID-19 reinfection can occur even after vaccination though symptoms remain relatively mild and Sinopharm provides protection against severe infection for prevention of COVID-19. Keywords: COVID, Recurrence, Health workers, Vaccination, Infection

Genetic pattern of the COVID-19 course and reinfection

A new coronavirus infection (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out at the end of 2019 in Wuhan (China). The disease has become a global pandemic and claimed more than 6 million lives after spreading rapidly around the world. Issues related to the complicated course of COVID-19 mechanisms continue to be the subject of active study. It is known that morbidity and mortality increase dramatically with increasing age and concomitant diseases, including obesity, diabetes, cancer, and cardiovascular diseases. Although most infected people recover, even young and otherwise healthy patients can get sick with this disease. In this regard, an urgent task is to search for specific genetic factors that can explain the predisposition of people to infection and the development of a severe COVID-19 form. Human genetic determinants can provide the scientific basis for disease prediction and the development of personalized therapies to counteract the epidemic. In addition, cases of repeated infection with SARS-CoV-2 are increasingly being registered, which occurs 16 months after initial infection on average and depends on the virus genome structure. Studies conducted on sequencing viral genomes have shown that some patients were re-infected with the same strain of coronavirus, while others were different. This, in turn, causes researchers concerns about the effectiveness of immunity after infection and vaccine reliability. The genetic characteristics of a person and a virus commonly determine the tendency for reinfection. It is difficult to determine the true COVID-19 reinfection prevalence, which is explained by the low detectability of asymptomatic reinfection and the fact that many patients with a mild course of the disease were not tested at an early stage of the pandemic. Therefore, the true prevalence of reinfection with COVID-19 does not reflect the current reality. There are many more cases of reinfection than are described in the literature. In this regard, the true contribution of a virus genetic features to reinfection of COVID-19 can be determined only after population studies, and when developing immunization programs against a COVID-19, it is necessary to take into account the prevalence of reinfection in the population.

Likelihood of COVID-19 reinfection in an urban community cohort in Massachusetts.

BackgroundUnderstanding the association of prior SARS-CoV-2 infection with subsequent reinfection has public health relevance.ObjectiveTo explore COVID-19 severity and SARS-CoV-2 infection and reinfection rates.DesignRetrospective cohort study.SettingBoston, Massachusetts, during the first COVID-19 surge (01/01/2020–05/31/2020; Period-1) and after the first surge (06/01/2020–02/28/2021; Period-2); Period-2 included the second surge (11/01/2020–02/28/2021).ParticipantsPatients in an academic medical center and six community health centers who received a clinical diagnosis of COVID-19 between 01/01/2020 and 05/31/2020 or SARS-CoV-2 testing between 01/01/2020 and 02/28/2021.MeasurementsCOVID-19 severity was compared between Period-1 and Period-2. Poisson regression models adjusted for demographic variables, medical comorbidities, and census tract were used to assess reinfection risk among patients with COVID-19 diagnoses or SARS-CoV-2 testing during Period-1 and additional SARS-CoV-2 testing during Period-2.ResultsAmong 142,047 individuals receiving SARS-CoV-2 testing or clinical diagnoses during the study period, 15.8% were infected. Among COVID-19 patients, 22.5% visited the emergency department, 13% were hospitalized, and 4% received critical care. Healthcare utilization was higher during Period-1 than Period-2 (22.9% vs. 18.9% emergency department use, 14.7% vs. 9.9% hospitalization, 5.5% vs. 2.5% critical care; p < 0.001). Reinfection was assessed among 8961 patients with a SARS-CoV-2 test or COVID-19 diagnosis in Period-1 who underwent additional testing in Period-2. A total of 2.7% (n = 65/2431) with SARS-CoV-2 in Period-1 tested positive in Period-2, compared with 12.6% (n = 821/6530) of those who initially tested negative (IRR of reinfection = 0.19, 95% CI: 0.15–0.25).ConclusionsPrior SARS-CoV-2 infection among this observational cohort was associated with an 81% lower reinfection rate.