Abstract
Background: The factors associated with severe acute respiratory coronavirus 2 (SARS-CoV-2) reinfection remain poorly defined.
Methods: We identified patients with SARS-CoV-2 infection and at least 1 repeat reverse transcription polymerase chain reaction result a minimum of 90 days after the initial positive test and before 21 January 2021. Those with a repeat positive test were deemed to have reinfection (n = 75), and those with only negative tests were classified as convalescents (n = 1594). Demographics, coronavirus disease 2019 (COVID-19) severity, and treatment histories were obtained from the Boston Medical Center electronic medical record. Humoral responses were analyzed using SARS-CoV-2-specific enzyme-linked immunosorbent assays and pseudovirus neutralizations in a subset of reinfection (n = 16) and convalescent samples (n = 32). Univariate, multivariate, and time to event analyses were used to identify associations.
Results: Individuals with reinfection had more frequent testing at shorter intervals compared with the convalescents. Unstable housing was associated with more than 2-fold greater chance of reinfection. Preexisting comorbidities and COVID-19 severity after the initial infection were not associated with reinfection. SARS-CoV-2 immunoglobulin G levels and pseudovirus neutralization were not different within the early weeks after primary infection and at a timepoint at least 90 days later in the 2 groups. In the convalescents, but not in those with reinfection, the late as compared with early humoral responses were significantly higher.
Conclusions: Reinfection associates with unstable housing, which is likely a marker for virus exposure, and reinfection occurs in the presence of SARS-CoV-2 antibodies.
Keywords: SARS-CoV-2; antibody neutralization; homeless; persistent shedding; reinfection.
【저자키워드】 SARS-CoV-2, reinfection., Antibody neutralization, homeless, persistent shedding, 【초록키워드】 COVID-19, coronavirus disease, antibody, neutralization, severity, Infection, COVID-19 severity, Comorbidity, virus, enzyme-linked immunosorbent assay, Reinfection, SARS-CoV-2 antibodies, Humoral response, Immunoglobulin, pseudovirus, reverse transcription, convalescent, Primary infection, marker, Factor, individual, center, Positive test, Boston, negative test, Respiratory Coronavirus, polymerase chain, initial, treatment history, greater, defined, analyzed, identify, were used, occur, analysis, significantly higher, groups, subset, not different, interval, associations, had more, patients with SARS-CoV-2, Unstable, 【제목키워드】 coronavirus 2, respiratory, Associate, Presence, Unstable,