Long COVID more likely after first infection

NEW YORK, July 14: A comprehensive study utilizing health records from nearly 213,000 Americans has revealed critical insights into COVID-19 reinfections, suggesting that the severity of initial infections could predict the severity of subsequent bouts with the virus. Published in Communications Medicine, the research underscores the persistence of severe COVID-19 impacts and the heightened risk of long-term COVID-19 following first-time infections.

The analysis drew upon electronic health records from 3.1 million individuals enrolled in the National COVID Cohort Collaborative (N3C), focusing on 212,984 cases of reinfections among those initially infected between March 1, 2020, and December 31, 2022. By March 2023, these individuals had experienced subsequent infections, with the majority encountering COVID-19 twice, while a smaller cohort faced three or more episodes.

Key findings indicated that individuals with severe initial infections, necessitating hospitalization, were significantly more likely to require hospital care during subsequent reinfections. Adults aged 60 and older, alongside those with underlying health conditions, exhibited heightened susceptibility to severe COVID-19 outcomes across both initial and subsequent infections.

The occurrence of reinfections peaked during periods when the omicron variant dominated transmissions in late 2021 and early 2022. Researchers attributed this surge to potential waning immunity and increased exposure to highly infectious variants circulating during those periods.

Notably, the study also highlighted disparities in long COVID prevalence between first infections and reinfections. Symptoms of long COVID-19, including persistent fatigue, coughing, and cognitive difficulties post-infection, were more prevalent among individuals after their initial encounter with the virus compared to subsequent reinfections.

Further insights revealed that lower levels of albumin, a liver-produced protein, could serve as a potential biomarker for increased reinfection risk. Researchers suggested exploring nutritional interventions and clinical trials to assess whether boosting albumin levels might mitigate reinfection risk and severity.

The study’s findings provide crucial data for ongoing efforts to understand COVID-19 immunity dynamics and inform strategies aimed at reducing severe outcomes and long-term health impacts associated with the virus.