SARS-CoV-2 Reinfection is Preceded by Unique Biomarkers and Related to Initial Infection Timing and Severity: an N3C RECOVER EHR-Based Cohort Study.

• Type of Material: Article
• Authors: Emily Hadley, RTI International; Yun Jae Yoo, Stony Brook University; Saaya Patel, Stony Brook University; Andrea Zhou, University of Virginia, Charlottesville; Bryan Laraway, TISLab, Aurora; Rachel Wong, Stony Brook University; Alexander Preiss, RTI International; Rob Chew, RTI International; Hannah Davis, RECOVER Patient Led Research Collaborative (PLRC); Christopher G Chute, Johns Hopkins University; Emily R Pfaff, University of North Carolina; Johanna Loomba, University of Virginia, Charlottesville; Melissa Haendel, University of Colorado; Elaine Hill, University of Rochester; Richard Moffitt, Emory University
• Language: English
• Date: 2023-01-05
• Publisher: medRxiv
• Publication Version: Preprint (Prior to Peer Review)
• Copyright Statement: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1101/2023.01.03.22284042
• Title of Journal or Parent Work: medRxiv
• Grant/Funding Information: This study was funded by the National Institutes of Health Agreement OTA OT2HL161847 as part of the Researching COVID to Enhance Recovery (RECOVER) research program.; This study is part of the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, which seeks to understand, treat, and prevent the post-acute sequelae of SARS-CoV-2 infection (PASC). For more information on RECOVER, visit https://recovercovid.org/. This research was funded by National Institutes of Health (NIH) Agreement OTA OT2HL161847 as part of the Researching COVID to Enhance Recovery (RECOVER) research program. The Data Use Request (DUR) ID is DUR-94BBC49.
• Keywords: Biomarkers; SARS-CoV-2

Abstract

Although the COVID-19 pandemic has persisted for over 2 years, reinfections with SARS-CoV-2 are not well understood. We use the electronic health record (EHR)-based study cohort from the National COVID Cohort Collaborative (N3C) as part of the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative to characterize reinfection, understand development of Long COVID after reinfection, and compare severity of reinfection with initial infection. We validate previous findings of reinfection incidence (5.9%), the occurrence of most reinfections during the Omicron epoch, and evidence of multiple reinfections. We present novel findings that Long COVID diagnoses occur closer to the index date for infection or reinfection in the Omicron BA epoch. We report lower albumin levels leading up to reinfection and a statistically significant association of severity between first infection and reinfection (chi-squared value: 9446.2, p-value: 0) with a medium effect size (Cramer’s V: 0.18, DoF = 4).