Re-infection with SARS-CoV-2 in Patients Undergoing Serial Laboratory Testing

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Abstract

Background

A better understanding of re-infection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become one of the healthcare priorities in the current pandemic. We determined the rate of re-infection, associated factors and mortality during follow up in a cohort of patients with SARS-CoV-2 infection.

Methods

We analyzed 9,119 patients with SARS-CoV-2 infection who received serial tests in total of 62 healthcare facilities in United States between December 1, 2019 to November 13, 2020. Re-infection was defined by two positive tests separated by interval of greater than 90 days two after resolution of first infection was confirmed by two or more consecutive negative tests. We performed logistic regression analysis to identify demographic and clinical characteristics associated with re-infection.

Results

Re-infection was identified in 0.7% (n=63, 95% confidence interval [CI] 0.5%-0.9%) during follow up of 9,119 patients with SARS-CoV-2 infection. The mean period (±standard deviation [SD]) between two positive tests was 116 ± 21 days. A logistic regression analysis identified that asthma (odds ratio [OR] 1.9, 95% CI 1.1-3.2) and nicotine dependence/tobacco use (OR 2.7, 95% CI 1.6-4.5) were associated with re-infection. There was a significantly lower rate of pneumonia, heart failure, and acute kidney injury observed with re-infection compared with primary infection among the 63 patients with re-infection There were two deaths (3.2%) associated with re-infection.

Conclusions

We identified a low rate of re-infection confirmed by laboratory tests in a large cohort of patients with SARS-CoV-2 infection. Although re-infection appeared to be milder than primary infection, there was associated mortality.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Infect Dis

Journal ID (iso-abbrev): Clin Infect Dis

Journal ID (publisher-id): cid

Title: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

Publisher: Oxford University Press (US )

ISSN (Print): 1058-4838

ISSN (Electronic): 1537-6591

Publication date (Electronic): 25 April 2021

Electronic Location Identifier: ciab345

Affiliations

[1 ] Department of Neurology, University of Missouri , MO, USA

[2 ] Institute for Data Science and Informatics, University of Missouri , MO, USA

[3 ] Department of Internal Medicine, University of Missouri, Columbia , MO, USA

[4 ] Department of Medicine, University of Missouri , MO, USA

[5 ] Department of Electrical Engineering and Computer Science, University of Missouri, Columbia , MO, USA

Author notes

Corresponding author: Name: Adnan I. Qureshi, Mail One Hospital Dr. CE507, Columbia, MO 65212, Email: qureshai@ 123456gmail.com , Phone: 973-280-9493, Fax: 573-884-4249

Article

Publisher ID: ciab345

DOI: 10.1093/cid/ciab345

PMC ID: 8135382

PubMed ID: 33895814

SO-VID: 87d428b7-a105-443d-86e7-0dbfd9e7729f

License:

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)