Multiple SARS-CoV-2 Infections May Elevate Risk of Organ Failure, Death

Individuals with COVID-19 reinfections were twice as likely to die and three times more likely to be hospitalized than those who did not have COVID-19 multiple times.

Repeat infections with COVID-19 were found to increase the risk of adverse health conditions in multiple organ systems, according to researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.

Since the COVID-19 pandemic began, investigators have found that an initial infection can cause short- and long-term health risks that impact nearly every organ system in the body. As the pandemic progressed, it has been observed that individuals can get COVID-19 a second or third time, even after acquiring natural antibodies after infections or receiving vaccination and booster shots.

Adverse outcomes include hospitalization and disorders that impact the lungs, heart, brain blood, musculoskeletal and gastrointestinal systems, as well as death. Reinfection also contributes to diabetes, kidney disease, and mental health issues.

“During the past few months, there’s been an air of invincibility among people who have had COVID-19 or their vaccinations and boosters, and especially among people who have had an infection and also received vaccines; some people started to referring to these individuals as having a sort of superimmunity to the virus,” said senior author Ziyad Al-Aly, MD, a clinical epidemiologist at the School of Medicine, in a press release. “Without ambiguity, our research showed that getting an infection a second, third or fourth time contributes to additional health risks in the acute phase, meaning the first 30 days after infection, and in the months beyond, meaning the long COVID phase.”

The researchers evaluated approximately 5.8 million deidentified medical records in a US Department of Veterans Affairs database, with patients representing multiple ages, races, and sexes.

A controlled data set included 5.3 million people who did not test positive for COVID-19 from March 1, 2020, through April 6, 2022. During the same time frame, the researchers identified a control group of more than 443,000 individuals who tested positive for an initial COVID-19 infection and another group of approximately 41,000 people who had 2 or more documented infections.

Out of the latter group, most people had 2 or 3 infections. A smaller population had 4 infections but there were no individuals found to have 5 or more infections. The investigators used statistical modeling to examine the health risks of repeat COVID-19 infections within the first 30 days post infection and up to 6 months after. The investigators evaluated COVID-19 variants such as delta, omicron, and BA.5, with negative outcomes observed among the unvaccinated and in those who received shots prior to reinfection.

The investigators found that individuals with COVID-19 reinfections were twice as likely to die and 3 times more likely to be hospitalized than those with no reinfection.

Individuals with repeat infections were also 3 and a half times more likely to develop lung problems, 3 times more likely to suffer heart conditions, and 1.6 times more likely to experience brain conditions than patients who had been infected with the virus once.

“Our findings have broad public health implications as they tell us that strategies to prevent or reduce the risk of reinfection should be implemented,” Al-Aly said in a press release. “Going into the winter season, people should be aware of the risks and practice vigilance to reduce their risk of infection or reinfection with SARS-CoV-2.”

REFERENCE

Repeat COVID-19 infections increase risk of organ failure, death. Washington University School of Medicine in St. Louis. November 10, 2022. Accessed November 11, 2022. https://medicine.wustl.edu/news/repeat-covid-19-infections-increase-risk-of-organ-failure-death/