Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social, Av. Javier Mina 301, Col. Centro, C.P. 28000, Colima, Colima, Mexico; Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Col. Las Víboras, C.P. 28040, Colima, Colima, Mexico.
Facultad de Ingeniería Civil, Universidad de Colima, Km. 9 Carretera Colima-Coquimatlán, Coquimatlán, C.P. 28400, Colima, Mexico.
Public Health. 2021 Apr;193:113-115. doi: 10.1016/j.puhe.2021.01.021. Epub 2021 Feb 12.
The aim of the study was to evaluate factors predicting severe symptomatic laboratory-confirmed (via Reverse transcription polymerase chain reaction, RT-PCR polymerase chain reaction) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection.
This is a nationwide retrospective cohort study that was conducted in Mexico.
Data from 258 reinfection cases (at least 28 days between both episodes onset) were analyzed. We used risk ratios (RRs) and 95% confidence intervals (CIs) to evaluate predictors of severe (dyspnea requiring hospital admission) secondary SARS-CoV-2 infection.
The risk of severe disease was 14.7%, and the observed overall fatality rate was 4.3%. Patients with more serious primary disease were more likely to develop severe symptoms (39.5% vs. 5.5%, P < 0.001) during reinfection. In multiple analysis, factors associated with an increased risk of severe symptomatic SARS-CoV-2 reinfection were increasing age (RR = 1.007, 95% CI = 1.003-1.010), comorbidities (namely, obesity [RR = 1.12, 95% CI = 1.01-1.24], asthma [RR = 1.26, 95% CI = 1.06-1.50], type 2 diabetes mellitus [RR = 1.22, 95% CI = 1.07-1.38]), and previous severe laboratory-confirmed coronavirus disease 2019 (RR = 1.20, 95% CI = 1.03-1.39).
To the best of our knowledge, this is the first study evaluating disease outcomes in a large set of laboratory-positive cases of symptomatic SARS-CoV-2 reinfection, and factors associated with illness severity were characterized. Our results may contribute to the current knowledge of SARS-CoV-2 pathogenicity and to identify populations at increased risk of a poorer outcome after reinfection.
本研究旨在评估预测严重症状性实验室确诊（通过逆转录聚合酶链反应[RT-PCR 聚合酶链反应]）严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）再感染的因素。
这是一项在墨西哥进行的全国性回顾性队列研究。
分析了 258 例再感染病例（两次发作之间至少间隔 28 天）的数据。我们使用风险比（RR）和 95%置信区间（CI）来评估严重（需要住院治疗的呼吸困难）继发性 SARS-CoV-2 感染的预测因素。
严重疾病的风险为 14.7%，观察到的总死亡率为 4.3%。初次疾病较严重的患者在再感染时更有可能出现严重症状（39.5% vs. 5.5%，P<0.001）。在多因素分析中，与严重症状性 SARS-CoV-2 再感染风险增加相关的因素包括年龄增长（RR=1.007，95%CI=1.003-1.010）、合并症（即肥胖[RR=1.12，95%CI=1.01-1.24]、哮喘[RR=1.26，95%CI=1.06-1.50]、2 型糖尿病[RR=1.22，95%CI=1.07-1.38]）和先前严重的实验室确诊的 2019 年冠状病毒病（RR=1.20，95%CI=1.03-1.39）。
据我们所知，这是第一项评估大量症状性 SARS-CoV-2 再感染的实验室阳性病例疾病结局的研究，并对与疾病严重程度相关的因素进行了描述。我们的研究结果可能有助于了解 SARS-CoV-2 的致病性，并确定再感染后结局较差的高危人群。
