First Wave Of COVID-19 Research Articles

Changing Images? Italian Twitter Discourse on China and the United States during the First Wave of COVID-19

ABSTRACT Although public diplomacy and its influence on foreign public opinion have been central themes in recent research, the latter often lacks methodological diversity and does not consider how states create competing images. Our study offers a framework for understanding Italian public opinion using a triangulation approach that combines traditional public opinion surveys with advanced text analysis of social media content. We compare the representation of China and the United States in the Italian Twitter community during the first wave of the COVID-19 pandemic. Our analysis shows that Italians who perceived China as a viable alternative to Western governments in public opinion surveys did so because they distrusted Western leaders and institutions.

Association of air pollution and weather conditions during infection course with COVID-19 case fatality rate in the United Kingdom

Although the relationship between the environmental factors, such as weather conditions and air pollution, and COVID-19 case fatality rate (CFR) has been found, the impacts of these factors to which infected cases are exposed at different infectious stages (e.g., virus exposure time, incubation period, and at or after symptom onset) are still unknown. Understanding this link can help reduce mortality rates. During the first wave of COVID-19 in the United Kingdom (UK), the CFR varied widely between and among the four countries of the UK, allowing such differential impacts to be assessed. We developed a generalized linear mixed-effect model combined with distributed lag nonlinear models to estimate the odds ratio of the weather factors (i.e., temperature, sunlight, relative humidity, and rainfall) and air pollution (i.e., ozone, N{O}_{2}, S{O}_{2}, CO, P{M}_{10} and P{M}_{2.5}) using data between March 26, 2020 and September 15, 2020 in the UK. After retrospectively time adjusted CFR was estimated using back-projection technique, the stepwise model selection method was used to choose the best model based on Akaike information criteria and the closeness between the predicted and observed values of CFR. The risk of death reached its maximum level when the low temperature (6 °C) occurred 1 day before (OR 1.59; 95% CI 1.52–1.63), prolonged sunlight duration (11–14 h) 3 days after (OR 1.24; 95% CI 1.18–1.30) and increased P{M}_{2.5} (19 μg/m3) 1 day after the onset of symptom (OR 1.12; 95% CI 1.09–1.16). After reopening, many COVID-19 cases will be identified after their symptoms appear. The findings highlight the importance of designing different preventive measures against severe illness or death considering the time before and after symptom onset.

COVID angels fighting daily demons? Mental well-being of healthcare workers and religiosity

Relying on a unique survey of more than 15,000 healthcare workers conducted from June to August 2020 in Italy, we show that religious priming caused participants to have a less dramatic recollection of their distressful experience during the first wave of COVID-19. Consistent with the view that religiosity serves as a coping mechanism, this effect was stronger for those who were more exposed to the virus categories during the first wave of the pandemic (e.g hospital workers) and for respondents who faced more stressful situations, such as being reassigned due to the COVID-19 emergency, or working in a COVID-19-related specialty (e.g, emergency care). All things being equal, the effect was found to be stronger among nurses, who indeed were identified as “COVID angels” during the intense media campaign of the first wave. We find no evidence that the results are sensitive to either the timing of the survey response or distance from the main events recollected.

Generation Z fashion shopping behaviour during and after the COVID-19 pandemic: the effect of sustainable consumption

COVID-19 made significant changes in the fashion retail markets in European countries because stores were closed due to government restrictions. The study aims to examine the fashion shopping behaviour of Generation Z consumers before and during the first wave of COVID-19 and its influence on the future development of fashion shopping behaviour. Based on the literature review and knowledge gap identified, the authors developed hypotheses to examine the relationship between Fashion & Style (FAS), Sustainability (SUS), and Circular Fashion Economy (CFE) and their impact on shopping behaviour after the first wave of the COVID-19 pandemic. The authors analysed the results of the measurement model (n = 589) and the direct and indirect mediating effect of the latent variables on the shopping frequency before (BEFORE) the pandemic and on the shopping frequency during the pandemic (DURING) and after the pandemic (AFTER). The results of the measurement model show that significant relationships exist in the proposed model, namely, the relationship between IS and SFB, FAS and SFD, SUS and SFD, SUS and CHA, FC and CHA, and SFD and CHA. Furthermore, the selected demographic variables acted as a mediator for the measurement model.

RETRACTED: Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: An estimate

BackgroundDuring the first wave of COVID-19, hydroxychloroquine (HCQ) was used off-label despite the absence of evidence documenting its clinical benefits. Since then, a meta-analysis of randomised trials showed that HCQ use was associated with an 11% increase in the mortality rate. We aimed to estimate the number of HCQ-related deaths worldwide. Methods and findingsWe estimated the worldwide in-hospital mortality attributable to HCQ use by combining the mortality rate, HCQ exposure, number of hospitalised patients, and the increased relative risk of death with HCQ. The mortality rate in hospitalised patients for each country was calculated using pooled prevalence estimated by a meta-analysis of published cohorts. The HCQ exposure was estimated using median and extreme estimates from the same systematic review. The number of hospitalised patients during the first wave was extracted from dedicated databases. The systematic review included 44 cohort studies (Belgium: k = 1, France: k = 2, Italy: k = 12, Spain: k = 6, Turkey: k = 3, USA: k = 20). HCQ prescription rates varied greatly from one country to another (range 16–84%). Overall, using median estimates of HCQ use in each country, we estimated that 16,990 HCQ-related in-hospital deaths (range 6267–19256) occurred in the countries with available data. The median number of HCQ-related deaths in Belgium, Turkey, France, Italy, Spain, and the USA was 240 (range not estimable), 95 (range 92–128), 199 (range not estimable), 1822 (range 1170–2063), 1895 (range 1475–2094) and 12739 (3244− 15570), respectively. ConclusionsAlthough our estimates are limited by their imprecision, these findings illustrate the hazard of drug repurposing with low-level evidence.

SARS-CoV-2 clearance in term of Cycle Threshold (Ct) during first two waves of COVID-19 in Pakistan: a phenomenon of delayed viral clearance post-corticosteroid treatment.

SARS-CoV-2 is recently emerged virus, which caused millions of deaths, all over the world. To tackle COVID-19 pandemic, there is an utmost need for in-depth analysis of viral replication. We aimed to examine viral load in SARS-CoV-2 patients during first two waves of COVID-19 in Pakistan. 225,615 suspected subjects from 75 different regions of Pakistan were selected in the study. SARS-CoV-2 RNAs were detected via real time PCR. During first wave (period of June-July, 2020) of COVID-19 the prevalence of SARS-CoV-2 was 20.38%. However, during second wave (period of November-December, 2020) of COVID-19, the rate of prevalence was 9.41%. During first wave of COVID-19 96.31% of participants remained PCR positive for 14 to 21 days, 3.39% of subjects showed positive results for 22 to 35 days, while delayed Ct values were observed among 0.26% of participants for 36 to 49 days. However, during second wave of COVID-19 89.31% of the subjects exhibited symptoms and showed real-time PCR positive results for 14 to 21 days, 9.42% showed positive results for 22 to 35 days, while significantly delayed Ct value results were observed among 1.026% of participants for 36 to 63 days (3.95 times higher than first wave). In contrast to first wave of COVID-19, the factors that were different in second wave were neither viral (different strains) nor host (same population). But treatment factors changed significantly. As during second wave besides azithromycin, corticosteroid dexamethasone consumption was increased consequently causing delayed Ct value negativity. This suggests that corticosteroid treatment might be linked with delayed Ct value or viral clearance. This study is crucial for re-considering effective therapeutic options against COVID-19.

Military affected by the first wave of COVID-19 in Senegal: stress and resilience factors during care.

COVID-19 had a psychological impact on the population, particularly those affected. Our objective was to investigate stress and resilience factors in the Senegalese soldiers affected during the first wave of COVID-19. Our retrospective and qualitative study included military personnel listed as contacts, suspects, or positive cases and supported by the Armed Forces Psychological Support Program during the period of isolation. The stress factors were health-related, sociological, and occupational. The conditions and the experience of isolation, stigmatization, and suspension of their professional projects were concerns for the soldiers. They had relied on personal, familial, and professional resources to cultivate resilience during the quarantine. Isolation during the pandemic showed psychological consequences, the foundations of which have been found in our study.

Pediatric COVID-19: clinical and epidemiological data of 1303 cases in a general hospital in Brazil.

This study aimed to describe the clinical characteristics of the pediatric population with COVID-19 in an Emergency Department (ED) of a Brazilian general hospital. Epidemiological and clinical data of patients younger than 20 years old were collected from patients' medical records from February 2020 to July 2021. Most of the epidemiological data described pertains to hospitalized patients. We also reviewed coinfections, treatment, and outcomes and compared the first and second waves of COVID-19. We identified a total of 1303 episodes of SARS-CoV-2 infection. The median time from symptom onset to diagnosis was three days. Symptoms were present in 92.3% of the patients. The most common symptoms were fever (45.2%), nasal congestion/discharge (44.2%), and cough (39.4%). Chest radiography and tomography were performed in 7.7 and 3.3% of cases, with abnormal findings in 29.7 and 53.4%, respectively. Hospital admissions occurred in 3.5% of patients, mainly in the presence of comorbidities, in children under five years old and in those who presented to the ED during the first wave of COVID-19. Coinfection with a viral agent was identified in 20% of the 71 cases tested in this study, and a positive rapid test for Streptococcus pyogenes was found in 8% of the 174 cases tested, with no impact of these coinfections on hospitalization. We found that COVID-19 was a mild disease in most children in our study population, with most hospitalizations and readmissions occurring during the first wave of COVID-19.

Social Responsibility and Commitment to Children; Pediatric Nurses' Experiences With Redeployment During the First Wave of COVID-19: A Qualitative Study.

COVID-19 represented a challenge for health care worldwide and led to new tasks and a rethinking of resource use. It was necessary to establish capacity within hospitals and to reassign critical resources between hospitals. This study aimed to explore pediatric nurses' experiences of redeployment, new tasks, and use of specialized competencies during the first wave of COVID-19. An exploratory design, involving qualitative individual interviews with 12 pediatric nurses was used. The analysis resulted in 3 main themes. Firstly, a feeling of social responsibility focused on how pediatric nurses felt committed to use their competencies during the crisis, whether they remained on the pediatric ward or were redeployed. Secondly, fewer children to counterbalance the shortage of pediatric nurses showed how redeployment was offset by fewer pediatric patients. Thirdly, adapting pediatric nursing competencies to new tasks described how the nurses adapted their skills to new tasks either in pediatric or adult wards. The results revealed that pediatric nurses had a social and ethical commitment to society in a crisis. They agreed to be redeployed and take on new tasks but were still concerned about the health and well-being of the children and their families, which led to a sense of ambivalence. They questioned whether their skills were being used appropriately in redeployment to adult wards. Fewer pediatric patients mitigated the workload of the remaining nurses. There is a risk of neglecting the needs of hospitalized children and their families during a pandemic. There was concern that "voluntary coercion" was a counterproductive strategy for reassignment.

Domestic violence patterns in postpartum women who delivered during the COVID-19 pandemic.

To longitudinally assess domestic violence (DV) during the postpartum period, identifying types, patterns and determinants of DV, according to mothers' reports in Fortaleza, Brazil. Data from the Iracema-COVID cohort study interviewed at home mothers who gave birth in the first wave of COVID-19, at 18 and 24 months after birth. Patterns of reported DV were classified as follows: no DV, interrupted DV, started DV and persistent DV. Adjusted multinomial logistic regressions were used to assess factors associated with persistent DV. DV was reported by 19 and 24% of the mothers at 18 and 24 months postpartum, respectively, a 5 percentage points increase. Persistent DV was present in 11% of the households in the period. The most frequent forms of DV were verbal aggression, reported by 17-20% of the mothers at 18 and 24 months, respectively; drunkenness or use of drugs at home, present in 3-5% of the households; physical aggression, reported by 1.2-1.6% of the mothers. Households with two or more forms of DV increased from 2 to 12% in the period. Adjusted factors associated with persistent DV were maternal common mental disorder, family headed by the mother and head of family's poor schooling. Food insecurity was associated with starting DV. Prevalence of DV was considerably high in the postpartum period. DV prevention policies should rely on improving care to women's mental health; preventing food insecurity; and fostering the educational level of young people of both sexes.

Physical activity, anxiety, depression, and coping in Turkish men and women during the first wave of COVID-19.

A need exists to better understand the relationships between COVID-19, coping behaviors, physical activity and stress, and COVID-19's impact on way of life. A cross-sectional study design was used to examine adult physical activity, hope, depression, anxiety, and coping status by gender during the COVID-19 pandemic, and to determine the impact of these variables on the coping process. The study also examined the effect of gender on the relation between physical activity and dependent variables. A global survey instrument was used in this study, including 1,400 Turkish adults. This study identified significant gender-based differences regarding physical activity, hope, depression, anxiety, and coping status of adults, although no significant gender-based difference was found regarding hope scores. Furthermore, physical activity directly influenced coping (β = 0.10), hope (β = 0.12), and anxiety (β = -0.08). Hope directly and positively influenced coping (β = 0.45) and directly and negatively influenced anxiety (β = -0.25) and depression (β = -0.28). Moreover, gender did not directly affect physical activity, but it was associated with decreased coping and increased depression and anxiety. Finally, gender had no effect on the relation between physical activity and hope, coping, depression, and anxiety (p > 0.01). These outcomes support the critical importance of physical activity and hope when coping with COVID-19 regardless of gender.

A Multisample Path Analysis Including a Novel Psychological Indicator, Attitude Toward Life, After the First Wave of COVID-19.

During the COVID-19 outbreak, China applied a unique volunteerism system in which nurses and physicians traveled to the epicenter to care for patients. During the same period, another group, nurse and physician nonvolunteers, stayed at their home hospitals outside of the epicenter and cared for patients without COVID-19. Yet only one Chinese study examined psychological responses comparing these groups. To explore whether relationships among compassion satisfaction, general health, attitude toward life, satisfaction with life, perceived stress, and posttraumatic stress disorder (PTSD) symptomatology differ between volunteers and nonvolunteers. Attitude toward life is examined for the first time in COVID-19 research. A cross-sectional study was conducted (259 nurse and physician volunteers, 330 nurse and physician nonvolunteers). Online survey data were analyzed using multisample path analysis. There was no significant difference between volunteer and nonvolunteer models. In the volunteer model, paths significantly related to PTSD symptomatology included compassion satisfaction (total effect, β = -0.12), general health (total effect, β = -0.09), attitude toward life (direct effect, β = -0.30; total effect, β = -0.30), and perceived stress (direct effect, β = 0.30; total effect, β = 0.30), and in nonvolunteers included general health (direct effect, β = -0.11; total effect, β = -0.11) and attitude toward life (direct effect, β = -0.47; total effect, β = -0.47). No significant difference between models means both groups could benefit from psychological intervention. Within each model, significant paths were identified. For volunteers, counselors might focus on compassion satisfaction and perceived stress and, for both volunteers and nonvolunteers, on health and attitude toward life. Delivering counseling based on key indicators in China may help prevent or mitigate PTSD. Globally, researchers could identify factors to target and determine to whom long-term counseling might be directed. Findings about attitude toward life lay the groundwork for future research.

Involvement of Institutional Workers in the Defence Sector during the First wave of COVID-19 in Kőbánya, Budapest

In the course of its measures to curb the spread of the epidemic, the government has decided to close numerous institutions or handed over the decision to the mayors in charge of defence. On 17 March 2020, following the decision of mayors in several districts, the local government of the capital decided to close the lockable playgrounds in addition to the educational institutions and draw parents’ attention to avoid using the playgrounds temporarily. In addition to implementing the decision, mayors had to do something to ensure the livelihoods of many institutional workers. In Kőbánya, this problem was remedied by involving institutional workers in defence. In this article, the author intends to present this process and its effects.

Effects of First Wave of COVID-19 on Colon Cancer Multi-disciplinary Team Performance: A Two-Year Analysis.

We investigated the effects of COVID-19-related delay on two-year outcomes of colon cancer treatment during the first wave of the pandemic. Ninety-two patients were referred for bowel cancer at our National Health Service (NHS) trust between March and July 2020, and 41 patients were treated for colon cancer and followed up (a two-year) through a multidisciplinary team (MDT). Treatment delays and overall survival (OS) were also assessed. Treatment delays were observed in 48% of patients. The average delay was 31 days beyond the 62-day mark (P0.001). Logistic and binary logistic regression models showed that a comorbid diagnosis of respiratory disease had a significant effect on delays in management and two-year outcomes (P=0.04), but without the likelihood of upstaging or a poorer outcome (P=0.942). The overall survival rate was 81.5%. Eight percent of bowel cancer surgeries could have been avoided if endoscopic visualization and biopsy were available, and 8% more surgeries could have been performed laparoscopically without fear of surrounding aerosols. The findings showed that oncologic care provided minimal disruption to trust during the COVID-19 pandemic owing to a quick association between the NHS site and a green non-NHS site, resulting in acceptable two-year outcomes for colon cancer patients.

Did Partial Lockdown Policy Effectively Reduce the First Wave of COVID-19 in Indonesia? A Regression Discontinuity Approach

One of the crucial issues in determining pandemic mitigation is deciding the optimal lockdown policy, whether a complete or partial lockdown could effectively reduce the spreading of COVID-19 without a vaccination policy, which could avoid global economic recession. The conventional pandemic model has limitations in predicting these linkages. The latest Causal Inference method that has been powerful in economic and health policy evaluation, such as Regressions Discontinuity Design (RDD), can contribute to this analysis. In contrast, RDD analysis in existing references is underused. This paper's objective is how the partial lockdown policy in Indonesia effects on spreading COVID-19 virus using RDD analysis. The results indicate that the partial lockdown policy reduced new cases of COVID-19 compared with having no partial lockdown policy. The results close to complete lockdown. This study uses panel data from official health, Waze, and other social variables. The pandemic model was developed from theoretical and empirical estimation. The spillover analysis was estimated using a Bayesian panel fixed-effect with Markov Chain Monte Carlo to relax the SUTVA problem. The DKI Jakarta has effectively reduced the spread of confirmed COVID-19 cases by about 10% to 22% from the baseline. The impact was less in West Java, at about 5%–18.5% from baseline. The government can control mobility during weekend periods and at the beginning of Ramadan. Policy enacted at the level of government (subdistrict level) most proximal to households had more influence on spillover effect reduction than those enacted at higher levels of government. The RDD analysis offers new implications to existing references for incorporating economic and pandemic variables for further research. Collaborating across the government level against the pandemic is paramount to controlling human mobility close to households.

Measuring hospital resilience before and during the COVID-19 pandemic

Organizational resilience scales have been adapted to the hospital context. To prepare for high consequence infectious diseases (HCID), the Long Hospital Resilience Scale (L-HRS; N=48) was tested in two German hospitals in 2019 and the Short Hospital Resilience Scale (S-HRS; N=317) after the first wave of COVID-19. Results show reliability of both the long and the short version. The L-HRS is associated with satisfaction with hospital preparation for HCID. S-HRS shows a perceived better adaptation of hospitals during COVID-19 and is related to higher self-efficacy of hospital staff. Both scales identify opportunities to promote resilience at various levels in the hospital.

Contexts of Extraordinary Parental Involvement in Children’s Education During the First Wave of COVID-19: A Case Study of a Public Elementary School in Poland

Objectives of the research: The purpose of the study was to learn about parents’ experiences of participating in their children’s remote education during the first wave of the COVID-19 pandemic. The question posed in this article is about the circumstances under which parents took over tasks previously perceived as a teacher’s job.
 Research methods: The participatory, qualitative case study utilized data from the open-ended questions of an electronic survey to which 104 parents (from a public elementary school in a metropolitan area) responded, as well as data from the school’s electronic register. The qualitative analysis employed strategies of constructivist grounded theory.
 Brief description of the context of the problem: While national and international studies have shown that parents played a critical role in the challenging and stressful home-based education of their children during the COVID-19 pandemic, no research has explained how parents became this vital link of education. The aim of this article is to fill this gap.
 Research findings: The study revealed two interrelated contextual factors that led to parents’ activation in their children’s “schooling from home”: 1) technical/administrative, related to having inadequate tools for distance education and 2) pedagogical/didactic, related to the prevailing concepts of teaching and learning being anchored in the behavioral-transmission paradigm.
 Conclusions and/or recommendations: The results apply primarily to the school under study and represent an intrinsic case study. However, it is reasonable to assume that the events, phenomena, and processes identified in the study may serve to explain phenomena in other schools that have organized distance education similarly. The cautious recommendation, aiming to safeguard family resources (thereby protecting equal opportunities for all children to learn) in times of crisis, is to transform the pedagogical underpinnings that shape today’s educational practices from behaviorist to constructivist. However, this requires further research.

Impact of First Wave of COVID-19 Pandemic on Mortality at Emergency Department in Older Patients with COVID and Non-COVID Diagnoses

Introduction: Mortality in emergency departments (EDs) is not well known. This study aimed to assess the impact of the first-wave pandemic on deaths accounted in the ED of older patients with COVID and non-COVID diseases. Methods: We used data from the Emergency Department and Elderly Needs (EDEN) cohort (pre-COVID period) and from the EDEN-COVID cohort (COVID period) that included all patients ≥65 years seen in 52 Spanish EDs from April 1 to 7, 2019, and March 30 to April 5, 2020, respectively. We recorded patient characteristics and final destination at ED. We compared older patients in the pre-COVID period, with older patients with non-COVID and with COVID-19. ED-mortality (before discharge or hospitalization) is the prior outcome and is expressed as an adjusted odds ratio (aOR) with 95% interval confidence. Results: We included 23,338 older patients from the pre-COVID period (aged 78.3 [8.1] years), 6,715 patients with non-COVID conditions (aged 78.9 [8.2] years) and 3,055 with COVID (aged 78.3 [8.3] years) from the COVID period. Compared to the older patients, pre-COVID period, patients with non-COVID and with COVID-19 were more often male, referred by a doctor and by ambulance, with more comorbidity and disability, dementia, nursing home, and more risk according to qSOFA, respectively (p < 0.001). Compared to the pre-COVID period, patients with non-COVID and with COVID-19 were more often to be hospitalized from ED (24.8% vs. 44.3% vs. 79.1%) and were more often to die in ED (0.6% vs. 1.2% vs. 2.2%), respectively (p < 0.001). Compared to the pre-COVID period, aOR for age, sex, comorbidity and disability, ED mortality in elderly patients cared in ED during the COVID period was 2.31 (95% confidence interval [CI]: 1.76–3.06), and 3.75 (95% CI: 2.77–5.07) for patients with COVID. By adding the variable qSOFA to the model, such OR were 1.59 (95% CI: 1.11–2.30) and 2.16 (95% CI: 1.47–3.17), respectively. Conclusions: During the early first pandemic wave of COVID-19, more complex and life-threatening older with COVID and non-COVID diseases were seen compared to the pre-COVID period. In addition, the need for hospitalization and the ED mortality doubled in non-COVID and tripled in COVID diagnosis. This increase in ED mortality is not only explained by the complexity or severity of the elderly patients but also because of the system’s overload.

Experience of Spinal Surgery for the Over 70s During the COVID-19 Pandemic in a Tertiary Referral Centre in the United Kingdom and Ramifications for Future Management.

The aim of this study was to assess the safety of our spinal surgery pathways for patients over the age of 70 years during the COVID-19 pandemic, to guide future management. A retrospective, single-centre, observational cohort study of all patients over 70 years of age undergoing spinal surgery between June 1 to September 30, 2020, was performed. All patients were stratified by the British Orthopaedic Association (BOA) COVID-19 Patient Risk Assessment Tool. A total of 64 operations on 59 patients were performed. The BOA risk assessment placed 67.8%of patients (n=40) in the high or very high-risk category. A total of 60% of patients (n=36) were over 75 years old. All patients had at least one other comorbidity. Following our green, amber, and red pathways, we had no cases of post-operative COVID-19 on an average follow-up of 71 days. Our study illustrates safe pathways for spinal surgery on patients over 70 years old during the first wave of COVID-19. Risk assessment tools should be used with caution, as age over 65 years was immediately medium-risk. This study would be a useful guide in the management of all elderly patients requiring surgery in the face of further COVID-19 variants or a similar pandemic.

Antibody response and risk of reinfection over 2 years among the patients with first wave of COVID-19

ObjectivesTo describe the dynamics and factors related to natural and hybrid humoral response against the SARS-CoV-2 and risk of reinfection among first-wave patients. MethodsA prospective longitudinal study with periodic serological follow-up after acute onset of all recovered patients with SARS-CoV-2 infection cared in Udine Hospital (March–May 2020). Nucleocapsid (N) protein and spike receptor-binding domain (S-RBD) antibody tests were used to distinguish natural and vaccine-induced response. ResultsOverall, 153 patients (66 men, mean age 56 years) were followed for a median of 27.3 (interquartile range 26.9–27.8) months. Seroreversion was 98.5% (95% CI: 96.8–99.4) for SARS-CoV-2-N IgM at 1 year and 57.4% (95% CI: 51.5–63.5) for SARS-CoV-2-N IgG at 2 years. Initial serological response (hazard ratio [HR]: 0.99, 95% CI: 0.99–0.99, p 0.002 for IgM and HR: 0.97, 95% CI: 0.97–0.98, p < 0.001 for IgG) and severity of acute infection (HR: 0.62, 95% CI: 0.39–0.96, p 0.033 for IgM and HR: 0.60, 95% CI: 0.37–0.99, p < 0.001 for IgG) were independently associated with persistent SARS-CoV-2-N IgM/IgG response. Older age and smoker status were associated with long-term SARS-CoV-2-N IgM and SARS-CoV-2-N IgG, respectively (HR: 0.75, 95% CI: 0.57–0.98, p 0.038; HR: 1.77, 95% CI: 1.19–2.61, p 0.004 respectively). All patients maintained SARS-CoV-2-S-RBD IgG response at 24-month follow-up. Reinfections occurred in 25 of 153 (16.3%) patients, mostly during the omicron circulation. Reinfection rates did not differ significantly between SARS-CoV-2-N IgG seronegative and seropositive patients (14/89, 15.7% vs. 10/62, 16.1%, p 0.947). Unvaccinated patients had higher risk of reinfection (4/7, 57.1% vs. vaccinated 21/146, 14.4%, p 0.014). DiscussionFirst-wave patients had durable natural humoral immunity in 40% and anti-S-RBD response in 100% up to 2 years after infection. Natural humoral response alone was not protective against reinfections with omicron SARS-CoV-2 variants, whereas vaccination was effective to reduce the risk of a new infection.