Many repeat infections are mild, but some studies suggest people who have been infected with COVID more than once are at a greater risk of severe disease or long COVID.
Reinfections with SARS-CoV-2, the virus that causes the disease, are on the rise, dashing hopes that vaccination or prior disease confers long-lasting immunity to infection. As more people get reinfected, they may be wondering: Do repeat infections lead to more severe COVID symptoms?
Given those findings, Al-Aly emphasizes that repeat infections are “consequential both in the acute and long COVID phase.” But his results also have important caveats: the VA patients were mostly older males, averaging 63 years in age, and many had preexisting health problems, including heart disease—all factors that can independently worsen COVID outcomes, Al-Aly says.
Among those hospitalized with severe COVID the first time around, nearly half were hospitalized again when reinfected. Conversely, roughly 90 percent of people with mild initial infections avoided hospitalization when sickened again with COVID later. Notably, the investigators found that reinfections were also associated with elevated risks of long COVID—lingering symptoms such as fatigue, shortness of breath and brain fog that persist months or years after an initial infection.
Richard Boucher, a pulmonologist at the UNC School of Medicine, agrees that people with widespread lung scarring face especially high risks from reinfection. “You worry about it in patients who had COVID and were left with severe pulmonary disease for months and months,” he says. “These patients are already behind the eight ball. You don’t want the virus to kick them again and add to the fibrosis they already have.
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