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Acute and postacute sequelae associated with SARS-CoV-2 reinfection

Open access
Bowe, Benjamin, Xie, Yan, Al-Aly, Ziyad·2022·Nature Medicine

Abstract

First infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risk of acute and postacute death and sequelae in various organ systems. Whether reinfection adds to risks incurred after first infection is unclear. Here we used the US Department of Veterans Affairs’ national healthcare database to build a cohort of individuals with one SARS-CoV-2 infection ( n = 443,588), reinfection (two or more infections, n = 40,947) and a noninfected control ( n = 5,334,729). We used inverse probability-weighted survival models to estimate risks and 6-month burdens of death, hospitalization and incident sequelae. Compared to no reinfection, reinfection contributed additional risks of death (hazard ratio (HR) = 2.17, 95% confidence intervals (CI) 1.93–2.45), hospitalization (HR = 3.32, 95% CI 3.13–3.51) and sequelae including pulmonary, cardiovascular, hematological, diabetes, gastrointestinal, kidney, mental health, musculoskeletal and neurological disorders. The risks were evident regardless of vaccination status. The risks were most pronounced in the acute phase but persisted in the postacute phase at 6 months. Compared to noninfected controls, cumulative risks and burdens of repeat infection increased according to the number of infections. Limitations included a cohort of mostly white males. The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.

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Metadata

Authors
Bowe, B., Xie, Y., & Al-Aly, Z.
Venue
Nature Medicine
Published
2022-11
Volume
28
Issue
11
Pages
2398-2405
ISSN
  • 1078-8956 (ISSN-L)
  • 1546-170X
OpenAlex
W4308767470
Cited by
639
References
40
FWCI
66.35
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Acute and postacute sequelae associated with SARS-CoV-2 reinfection. https://app.cochat.ai/papers/10.1038/s41591-022-02051-3
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Bowe, B., Xie, Y., & Al-Aly, Z. (2022). Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. https://doi.org/10.1038/s41591-022-02051-3

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