Citat:
Ursprungligen postat av
arbetet
Sjukhusinläggningar vanligare vid återinfektion (inte genombrottsinfektioner här) än vid den primära:
Rate and severity of suspected SARS-Cov-2 reinfection in a cohort of PCR-positive COVID-19 patients
Abstract
Objectives
To estimate the burden and severity of suspected reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods
A retrospective cohort of members of Kaiser Permanente Southern California with PCR-positive SARS-CoV-2 infection between 1st March 2020 and 31st October 2020 was followed through electronic health records for subsequent positive SARS-CoV-2 tests (suspected reinfection) ≥90 days after initial infection, through 31st January 2021. Incidence of suspected reinfection was estimated using the Kaplan–Meier method. Cox proportional hazards models estimated the association of suspected reinfection with demographic and clinical characteristics, hospitalization, and date of initial infection.
Results
The cohort of 75 149 was predominantly Hispanic (49 648/75 149, 66.1%) and included slightly more females than males (39 736, 52.9%), with few immunocompromised patients (953, 1.3%); 315 suspected reinfections were identified, with a cumulative incidence at 270 days of 0.8% (95% confidence interval (CI) 0.7–1.0%). Hospitalization was more common at suspected reinfection (36/315, 11.4%) than initial infection (4094/75 149, 5.4%). Suspected reinfection rates were higher in females (1.0%, CI 0.8–1.2% versus 0.7%, CI 0.5–0.9%, p 0.002) and immunocompromised patients (2.1%, CI 1.0–4.2% versus 0.8%, CI 0.7–1.0%, p 0.004), and lower in children than adults (0.2%, CI 0.1–0.4% versus 0.9%, CI 0.7–1.0%, p 0.023). Patients hospitalized at initial infection were more likely to have suspected reinfection (1.2%, CI 0.6–1.7% versus 0.8%, CI 0.7–1.0%, p 0.030), as were those with initial infections later in 2020 (150-day incidence 0.4%, CI 0.2–0.5% September–October versus 0.2%, CI 0.1–0.3% March–May and 0.3%, CI 0.2–0.3% June–August, p 0.008). In an adjusted Cox proportional hazards model, being female (hazard ratio (HR) 1.44, CI 1.14–1.81), adult (age 18–39, HR 2.71, CI 1.38–5.31, age 40–59 HR 2.22, CI 1.12–4.41, age ≥60 HR 2.52, CI 1.23–5.17 versus <18 years), immunocompromised (HR 2.48, CI 1.31–4.68), hospitalized (HR 1.60, CI 1.07–2.38), and initially infected later in 2020 (HR 2.26, CI 1.38–3.71 September–October versus March–May) were significant independent predictors of suspected reinfection.
Conclusions
Reinfection with SARS-CoV-2 is uncommon, with suspected reinfections more likely in women, adults, immunocompromised subjects, and those previously hospitalized for coronavirus 2019 (COVID-19). This suggests a need for continued precautions and vaccination in patients with COVID-19 to prevent reinfection.
https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00422-5/fulltext
Jag tycker alla kan dra sina egna slutsatser.
1.
Endast 0,8% återinfekterades.
”There were 315 suspected reinfections identified, with an overall cumulative incidence of 0.8% (95% confidence interval (CI) 0.7–1.0%) at 270 days following initial infection.”
2.
Endast 0,05% av de som hade infekterats blev smittade igen OCH behövde sjukhusvård. De flesta med underliggande sjukdomar som förmodligen förvärrats under 270 dagar
”This may be because patients with COVID-19 were more likely to be hospitalized if they had high-risk conditions, which may have also increased susceptibility for reinfection.”
3.
De mätte förmodade infektioner Hela slutsatsen bygger på vad förmodligen är en överestimering och därför används termen ”suspected” i hela artikeln
”Our study has potential limitations. We did not perform genetic sequencing to verify new infection or viral culture to demonstrate live virus at suspected reinfection, and Ct values, close-contact exposure history, and symptoms were unavailable.”
” Hospitalization defined as COVID-19 diagnosis on admission likely included some admissions for other reasons.”
Slutsats: Om 0,8% återinfekteras och 0,05% riskerar sjukhusvård är vaccin knappast motiverat för alla. 5-10% av alla barn behöver akutvårdas för fallolyckor varje år. Jämför gärna och fundera på varför det är sådan hysteri kring 0,05% risk, bland gamla och sjuka dessutom, när vi utsätter våra barn för betydligt större risker varje dag utan eftertanke. 100 x större risk faktiskt.
