A 1 to 1000 SARS-CoV-2 reinfection proportion in members of a large healthcare provider in Israel: a preliminary report

Perez, Galit; Banon, Tamar; Gazit, Sivan; Sb, Moshe; Wortsman, Joshua; Grupel, Daniel; Peretz, Asaf; Ab, Tov; Chodick, Gabriel; Mizrahi-Reuveni, Miri; Patalon, Tal

doi:10.1101/2021.03.06.21253051

Cited by 28 publications

(62 citation statements)

References 14 publications

(15 reference statements)

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“…Overall, we observed that (i) if the time lag between discharge and RP of SRAS-CoV-2 is at most 28 days, these might be reinfection or relapse of previous infection; (ii) if the time lag is 2 months, it is more likely to be reinfection; and (iii) if the time lag is 3 months or above, it is very likely to be true reinfection (17). However, the most reliable way is to perform sequencing twice and get two different strains of the virus.…”

Section: Discussionmentioning

confidence: 77%

“…However, this issue needs urgent attention to investigate whether RP-SARS-CoV-2 patients could be a serious public health problem. However, some studies reported that a small proportion (about 1%) of the population can be RP for SARS-CoV-2, and possibly due to reactivation or reinfection (16,17). Furthermore, previous reports (7,34,35) highlighted that RP-SARS-CoV-2 is less likely to cause serious problems to public health since the rate of RP seems low (about 1%), and new infections declining after recovery from the first episode of the infection (16,35), which is likely due to the suspected herd immunity (97,98).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the issue of reinfection (SARS-CoV-2 subsequent infection after recovery from previous episode of the infection) and reactivation (also known as relapse, a re-detectable positive SARS-CoV-2 viral RNA in recovered patient which occurs within the first 4 weeks of previous infection) have been reported in several studies [see for instance (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), and the references therein]. These studies highlighted the possibility of reactivation and reinfection of SARS-CoV-2 which needs urgent attention from the researchers as well the public health policymakers.…”

Section: Introductionmentioning

confidence: 99%

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Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review

Tang

Musa

Zhao

et al. 2021

Front. Public Health

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As the pandemic continues, individuals with re-detectable positive (RP) SARS-CoV-2 viral RNA among recovered COVID-19 patients have raised public health concerns. It is imperative to investigate whether the cases with re-detectable positive (RP) SARS-CoV-2 might cause severe infection to the vulnerable population. In this work, we conducted a systematic review of recent literature to investigate reactivation and reinfection among the discharged COVID-19 patients that are found positive again. Our study, consisting more than a total of 113,715 patients, indicates that the RP-SARS-CoV-2 scenario occurs plausibly due to reactivation, reinfection, viral shedding, or testing errors. Nonetheless, we observe that previously infected individuals have significantly lower risk of being infected for the second time, indicating that reactivation or reinfection of SARS-CoV-2 likely have relatively less impact in the general population than the primary infection.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review

Tang

Musa

Zhao

et al. 2021

Front. Public Health

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“…24.21262415 doi: medRxiv preprint apart. 12 Using similar criteria, population-based studies demonstrated natural immunity 13,14 with no signs of waning immunity for at least 7 months, though protection was lower for those aged 65 or older 9 .…”

Section: Introductionmentioning

confidence: 98%

Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections

Gazit

Shlezinger

Perez

et al. 2021

Preprint

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173

145

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Background: Reports of waning vaccine-induced immunity against COVID-19 have begun to surface. With that, the comparable long-term protection conferred by previous infection with SARS-CoV-2 remains unclear. Methods: We conducted a retrospective observational study comparing three groups: (1)SARS-CoV-2-naive individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, (2)previously infected individuals who have not been vaccinated, and (3)previously infected and single dose vaccinated individuals. Three multivariate logistic regression models were applied. In all models we evaluated four outcomes: SARS-CoV-2 infection, symptomatic disease, COVID-19-related hospitalization and death. The follow-up period of June 1 to August 14, 2021, when the Delta variant was dominant in Israel. Results: SARS-CoV-2-naive vaccinees had a 13.06-fold (95% CI, 8.08 to 21.11) increased risk for breakthrough infection with the Delta variant compared to those previously infected, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant (P<0.001) for symptomatic disease as well. When allowing the infection to occur at any time before vaccination (from March 2020 to February 2021), evidence of waning natural immunity was demonstrated, though SARS-CoV-2 naive vaccinees had a 5.96-fold (95% CI, 4.85 to 7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51 to 9.21) increased risk for symptomatic disease. SARS-CoV-2-naive vaccinees were also at a greater risk for COVID-19-related-hospitalizations compared to those that were previously infected. Conclusions: This study demonstrated that natural immunity confers longer lasting and stronger protection against infection, symptomatic disease and hospitalization caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity. Individuals who were both previously infected with SARS-CoV-2 and given a single dose of the vaccine gained additional protection against the Delta variant.

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“…The course of COVID-19 in these people was mildly symptomatic and no one required hospitalization. SARS-CoV-2 infections after vaccination have been reported sporadically [37,38], but they raise important issues regarding the duration of immunity after natural infection and the extent of protection after vaccination, as well as the transmission of the virus. We conducted regular immunological surveillance for 8 seronegative participants and observed that 4 months after the rst vaccinations, anti-SARS-CoV-2 IgG levels were lower and continued to decline.…”

Section: Discussionmentioning

confidence: 99%

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

Tretyn

Szczepanek

Skorupa

et al. 2021

Preprint

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At the end of 2020, population-based vaccination programs with new generation mRNA-based vaccines began almost all over the world. The aim of the study was to evaluate the titer of anti-SARS-CoV-2 IgG antibodies against the S1 subunit of the virus’s spike protein as a marker of the humoral response in 477 patients and the concentration of gamma interferon as an indicator of a cellular response in 28 individuals. In our studies, we used serological enzyme-linked immunosorbent assays. IgG was measured in weeks 2 and 3 after the first dose and 1–5 weeks after the second dose of an mRNA vaccine in seropositive and seronegative individuals as well as in symptomatic and asymptomatic convalescents. High levels of antibodies were observed in 98% of our vaccinated cohort, and the presence of protective T cells was confirmed in the blood samples of all participants. The humoral immune response is diversified and is visible as early as 2–3 weeks after the first dose of the mRNA vaccine. The level of protection increased significantly after the second dose, with the increase being much greater in pre-vaccine healthy subjects and less in convalescents. In the second and third weeks after the second dose, the concentration of IgG antibodies was the highest, and in the following weeks, it decreased gradually. Regular serological measurements on eight subjects show that antibody titers are lower four months after vaccination than before the second dose.

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A 1 to 1000 SARS-CoV-2 reinfection proportion in members of a large healthcare provider in Israel: a preliminary report

Cited by 28 publications

References 14 publications

Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review

Reinfection or Reactivation of Severe Acute Respiratory Syndrome Coronavirus 2: A Systematic Review

Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections

Differences in the concentration of anti-SARS-CoV-2 IgG antibodies post-COVID-19 recovery or post-vaccination

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