COVID-19 reinfection in Liberia: Implication for improving disease surveillance

Akpan, Godwin E.; Bawo, Luke; Amo-Addae, Maame; Kennedy, Jallah; Wesseh, Chea Sanford; Whesseh, Faith; Adewuyi, Peter; Sanvee-Blebo, Lily; Babalola, Joseph; Sesay, Himiede W. W.; Yeabah, Trokon; Jackson, Dikena; Shannon, Fulton; Umeokonkwo, Chukwuma David; Nyenswah, Abraham W.; MaCauley, Jane; Jallah, Wilhelmina

doi:10.1371/journal.pone.0265768

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…In contrast, single epidemiological studies from Bahrain, Austria, Liberia, and Saudi Arabia have produced results that confirm the trends described by our research group [ 18 – 21 ].…”

Section: Discussionsupporting

confidence: 90%

Reinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland, April 2020 to July 2022

Morawiec¹,

Bednarska-Czerwińska²,

Pudełko³

et al. 2023

Med Sci Monit

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Background:The increasing number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections has opened a new research direction related to analyzing long-term immune response and accurately characterizing individual cases of reinfection to understand its mechanism and estimate the risk of widespread reinfection both locally and globally. This retrospective study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland aimed to evaluate reinfections from SARS-CoV-2 between April 2020 and July 2022. Material/Methods:The study extended the previously published report on SARS-CoV-2 infection cases in Poland by analyzing 8041 reinfections diagnosed with real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. Data were collected on the amount of time elapsed from the first infection to the next and, based on these data, all results were divided into several groups for statistical analysis: 0-44, 45-90, 91-200, 201-310, 311-420, and >420 (days). Results:The study showed that of the 8041 patients who experienced reinfection, the vast majority (5505) became reinfected more than 310 days after the original infection, even though the average time between infections was 354.3 days. Statistical analysis revealed that the risk of SARS-CoV-2 reinfection increases with time and that this relationship becomes statistically significant after the 200 th day following the initial infection (p<0.01). Conclusions:We have shown that acquired immunity to SARS-CoV-2 infection is relatively short-lived -it starts diminishing about 6 months after the initial positive test. Moreover, the risk of reinfection is very high more than 1 year after the initial infection.

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“…In contrast, single epidemiological studies from Bahrain, Austria, Liberia, and Saudi Arabia have produced results that confirm the trends described by our research group [ 18 – 21 ].…”

Section: Discussionsupporting

confidence: 90%

Reinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland, April 2020 to July 2022

Morawiec¹,

Bednarska-Czerwińska²,

Pudełko³

et al. 2023

Med Sci Monit

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“…Of the 3282 papers initially retrieved, we included 91 cohort studies evaluating the onset of reinfection, severe and very severe/lethal COVID‐19 among 15,034,624 previously infected subjects (Figure 1), either among health care workers (27 publications; n = 37,598 2,8,9,15,17,24,36,38,42–59 ) or in the general population (67 publications; n = 14,997,026 3–7,10,12,16–23,25–27,43,49,60–106 ).…”

Section: Resultsmentioning

confidence: 99%

“…Overall, a total of 158,478 reinfections were recorded among the 15,034,624 subjects with a previous infection, 2–10,12,13,15–27,36,38,42–107 corresponding to a pooled rate of 0.97% (95% CI: 0.71%–1.27%—Table 1; Figure 2). The summary rate of reinfection rose to 1.07% (95% CI: 0.73%–1.46%) when only the 69 datasets with a more conservative time lag of ≥90 days between the two episodes were considered 3–6,8–10,12,18–23,25,26,36,42–44,46–50,52–56,59,61–65,67–69,72–84,86,87,89,91–96,98,101,103,105–107 and it slightly varied by reinfection definition criteria (0.93% vs 1.01% when considering studies with high vs low risk of misclassification). The risk of reinfection was higher among health care workers as compared to the general population (1.20% vs 0.90), and among females (0.79% vs 0.55% among males), although these estimates showed largely overlapping confidence intervals.…”

Section: Resultsmentioning

confidence: 99%

“…As shown in Table S1, most of the included studies ( n = 43) were carried out in Europe, 2,4–10,12,15,17,18,21,24,26,36,38,44,46–51,58,66,69,71,72,75,81,85–88,91–93,95,99,102 24 in the USA, 20,22,23,25,42,43,57,59,63,67,77,79,82–84,89,90,97,98,103,105–107 18 in Asia 3,16,19,27,45,52–54,56,60,62,64,65,70,73,74,100,101 and the remaining six in South America or South Africa 61,68,80,94,96,104 . The mean age of the participants ranged from 15 to 87 years, and the average follow‐up ranged from 29 to 371 days.…”

Section: Resultsmentioning

confidence: 99%

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Risk of reinfection and disease after SARS‐CoV‐2 primary infection: Meta‐analysis

Flacco

Martellucci

Baccolini³

et al. 2022

Eur J Clin Investigation

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Introduction A precise estimate of the frequency and severity of SARS‐CoV‐2 reinfections would be critical to optimize restriction and vaccination policies for the hundreds of millions previously infected subjects. We performed a meta‐analysis to evaluate the risk of reinfection and COVID‐19 following primary infection. Methods We searched MedLine, Scopus and preprint repositories for cohort studies evaluating the onset of new infections among baseline SARS‐CoV‐2‐positive subjects. Random‐effect meta‐analyses of proportions were stratified by gender, exposure risk, vaccination status, viral strain, time between episodes, and reinfection definition. Results Ninety‐one studies, enrolling 15,034,624 subjects, were included. Overall, 158,478 reinfections were recorded, corresponding to a pooled rate of 0.97% (95% CI: 0.71%–1.27%), with no substantial differences by definition criteria, exposure risk or gender. Reinfection rates were still 0.66% after ≥12 months from first infection, and the risk was substantially lower among vaccinated subjects (0.32% vs. 0.74% for unvaccinated individuals). During the first 3 months of Omicron wave, the reinfection rates reached 3.31%. Overall rates of severe/lethal COVID‐19 were very low (2–7 per 10,000 subjects according to definition criteria) and were not affected by strain predominance. Conclusions A strong natural immunity follows the primary infection and may last for more than one year, suggesting that the risk and health care needs of recovered subjects might be limited. Although the reinfection rates considerably increased during the Omicron wave, the risk of a secondary severe or lethal disease remained very low. The risk–benefit profile of multiple vaccine doses for this subset of population needs to be carefully evaluated.

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“…The de nition of COVID-19 reinfection differed from author to author; some authors considered reinfection as a new positive PCR following two consecutive negative PCR taken after primary infection (53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66); some other studies considered reinfection as a new infection after 90 days of primary infection or after initial testing (29,36,(67)(68)(69)(70)(71)(72)(73)(74). Other studies considered reinfection as a new positive PCR 30-60 days after the rst cured infection (75)(76)(77)(78)(79), and for others, the de nition was retesting positive following prior complete recovery and/or after discharge (80-102).…”

Section: Study Selectionmentioning

confidence: 99%

Global prevalence of coronavirus disease 2019 reinfection: a systematic review and meta-analysis

Ukwishaka

Yves

Esmeralda

et al. 2023

Preprint

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Background In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged with a high transmissibility rate and resulted in numerous negative impacts on global life. Preventive measures such as facial masks, social distancing, and vaccination helped control the pandemic. Nonetheless, the emergence of SARS-CoV-2 variants, such as Omega and Delta, as well as coronavirus disease 2019 (COVID-19) reinfection, raise additional concerns. Therefore, this study aimed to determine the overall prevalence of reinfection on global and regional scales. Methods A systematic search was conducted across three databases, PubMed, Scopus, and ProQuest Central, including all articles pertaining to COVID-19 reinfection without language restriction. After critical appraisal and qualitative synthesis of the identified relevant articles, a meta-analysis considering random effects was used to pool the studies. Results We included 52 studies conducted between 2019 and 2022, with a total sample size of 3,623,655 patients. The overall prevalence of COVID-19 reinfection was 4.2% (95% confidence interval [CI]: 3.7–4.8%; n = 52), with high heterogeneity between studies. Africa had the highest prevalence of 4.7% (95% CI: 1.9–7.5%; n = 3), whereas Oceania and America had lower estimates of 0.3% (95% CI: 0.2–0.4%; n = 1) and 1% (95% CI: 0.8–1.3%; n = 7), respectively. The prevalence of reinfection in Europe and Asia was 1.2% (95% CI: 0.8–1.5%; n = 8) and 3.8% (95% CI: 3.4–4.3%; n = 43), respectively. Studies that used a combined type of specimen had the highest prevalence of 7.6% (95% CI: 5.8–9.5%; n = 15) compared with those that used oropharyngeal or nasopharyngeal swabs only that had lower estimates of 6.7% (95% CI: 4.8–8.5%; n = 8), and 3.4% (95% CI: 2.8–4.0%; n = 12) respectively. Conclusion COVID-19 reinfection occurs with varying prevalence worldwide, with the highest occurring in Africa. Therefore, preventive measures, including vaccination, should be emphasized to ensure control of the pandemic.

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COVID-19 reinfection in Liberia: Implication for improving disease surveillance

Cited by 11 publications

References 22 publications

Reinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland, April 2020 to July 2022

Reinfections from SARS-CoV-2: A Retrospective Study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland, April 2020 to July 2022

Risk of reinfection and disease after SARS‐CoV‐2 primary infection: Meta‐analysis

Global prevalence of coronavirus disease 2019 reinfection: a systematic review and meta-analysis

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