4.7 Article

Assessment of the Risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Reinfection in an Intense Reexposure Setting

Journal

CLINICAL INFECTIOUS DISEASES
Volume 73, Issue 7, Pages E1830-E1840

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciaa1846

Keywords

SARS-CoV-2; epidemiology; reinfection; immunity; genetics

Funding

  1. Biomedical Research Program at Weill Cornell Medicine-Qatar
  2. Biostatistics, Epidemiology, and Biomathematics Research Core at Weill Cornell Medicine-Qatar
  3. Genomics Core at Weill Cornell Medicine-Qatar
  4. Ministry of Public Health and Hamad Medical Corporation

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A study in Qatar found a low rate of reinfection with SARS-CoV-2, with most cases being asymptomatic and suggesting protective immunity lasting for at least a few months post primary infection.
Background. Risk of reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. We assessed the risk and incidence rate of documented SARS-CoV-2 reinfection in a cohort of laboratory-confirmed cases in Qatar. Methods. All SARS-CoV-2 laboratory-confirmed cases with at least 1 polymerase chain reaction-positive swab that was >= 45 days after a first positive swab were individually investigated for evidence of reinfection. Viral genome sequencing of the paired first positive and reinfection viral specimens was conducted to confirm reinfection. Results. Out of 133 266 laboratory-confirmed SARS-CoV-2 cases, 243 persons (0.18%) had at least 1 subsequent positive swab >= 45 days after the first positive swab. Of these, 54 cases (22.2%) had strong or good evidence for reinfection. Median time between the first swab and reinfection swab was 64.5 days (range, 45-129). Twenty-three of the 54 cases (42.6%) were diagnosed at a health facility, suggesting presence of symptoms, while 31 (57.4%) were identified incidentally through random testing campaigns/surveys or contact tracing. Only 1 person was hospitalized at the time of reinfection but was discharged the next day. No deaths were recorded. Viral genome sequencing confirmed 4 reinfections of 12 cases with available genetic evidence. Reinfection risk was estimated at 0.02% (95% confidence interval [CI], .01%-.02%), and reinfection incidence rate was 0.36 (95% CI, .28-.47) per 10 000 person-weeks. Conclusions. SARS-CoV-2 reinfection can occur but is a rare phenomenon suggestive of protective immunity against reinfection that lasts for at least a few months post primary infection.

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