SARS-CoV-2 reinfection in 43,000 antibody-positive individuals followed up to 35 weeks

 

View ORCID ProfileLaith J Abu-Raddad,  View ORCID ProfileHiam Chemaitelly,  View ORCID ProfilePeter Coyle,  View ORCID ProfileJoel A Malek, Ayeda A. Ahmed, Yasmin A. Mohamoud, Shameem Younuskunju,  View ORCID ProfileHoussein H. Ayoub,  View ORCID ProfileZaina Al Kanaani,  View ORCID ProfileEinas Al Kuwari,  View ORCID ProfileAdeel A Butt,  View ORCID ProfileAndrew Jeremijenko,  View ORCID ProfileAnvar Hassan Kaleeckal, Ali Nizar Latif,  View ORCID ProfileRiyazuddin Mohammad Shaik,  View ORCID ProfileHanan F. Abdul Rahim,  View ORCID ProfileGheyath K. Nasrallah,  View ORCID ProfileHadi M. Yassine,  View ORCID ProfileMohamed G. Al Kuwari,  View ORCID ProfileHamad Eid Al Romaihi,  View ORCID ProfileMohamed H. Al-Thani, Abdullatif Al Khal,  View ORCID ProfileRoberto Bertollini

doi: https://doi.org/10.1101/2021.01.15.21249731

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.01.15.21249731v1.full.pdf

Abstract

Background: Reinfection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented, raising public health concerns. Risk and incidence rate of SARS-CoV-2 reinfection were assessed in a large cohort of antibody-positive persons in Qatar. Methods: All SARS-CoV-2 antibody-positive persons with a PCR-positive swab ≥14 days after the first-positive antibody test were individually investigated for evidence of reinfection. Viral genome sequencing was conducted for paired viral specimens to confirm reinfection. Results: Among 43,044 anti-SARS-CoV-2 positive persons who were followed for a median of 16.3 weeks (range: 0-34.6), 314 individuals (0.7%) had at least one PCR positive swab ≥14 days after the first-positive antibody test. Of these individuals, 129 (41.1%) had supporting epidemiological evidence for reinfection. Reinfection was next investigated using viral genome sequencing. Applying the viral-genome-sequencing confirmation rate, the risk of reinfection was estimated at 0.10% (95% CI: 0.08-0.11%). The incidence rate of reinfection was estimated at 0.66 per 10,000 person-weeks (95% CI: 0.56-0.78). Incidence rate of reinfection versus month of follow-up did not show any evidence of waning of immunity for over seven months of follow-up. Efficacy of natural infection against reinfection was estimated at >90%. Reinfections were less severe than primary infections. Only one reinfection was severe, two were moderate, and none were critical or fatal. Most reinfections (66.7%) were diagnosed incidentally through random or routine testing, or through contact tracing. Conclusions: Reinfection is rare. Natural infection appears to elicit strong protection against reinfection with an efficacy >90% for at least seven months.  

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The authors are grateful for support from the Biomedical Research Program, the Biostatistics, Epidemiology, and Biomathematics Research Core, and the Genomics Core, all at Weill Cornell Medicine-Qatar, as well as for support provided by the Ministry of Public Health and Hamad Medical Corporation. The statements made herein are solely the responsibility of the authors.

https://www.medrxiv.org/content/10.1101/2021.01.15.21249731v1