Acute and postacute sequelae associated with SARS-CoV-2 reinfection

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Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Reinfection with COVID-19 Increases Risks of Death and Long COVID, Even After Vaccination

This study, using data from the US Department of Veterans Affairs, found that reinfection with SARS-CoV-2 increased the risk of death, hospitalization, and a range of health problems across various organ systems, even for those who were vaccinated. These risks were higher in the acute phase but persisted for at least six months after reinfection, with cumulative risks increasing with each subsequent infection.

Possible Conflicts of Interest

None identified

Identified Weaknesses

Cohort limitations

The study primarily focused on older, white male veterans, limiting the generalizability of the findings to other populations, such as younger individuals, women, and people of different ethnic backgrounds.

Potential for misclassification

The study relied on positive SARS-CoV-2 tests to define infection and reinfection, potentially missing asymptomatic or mildly symptomatic cases who didn't get tested, which could underestimate the true risks of reinfection.

Residual confounding

Despite statistical adjustments, the possibility of unmeasured or unknown confounders influencing the observed associations cannot be entirely ruled out.

Evolving nature of the pandemic

The ongoing evolution of the virus, emergence of new variants, and changing vaccination patterns could influence the dynamics of reinfection and its health consequences over time, affecting the long-term applicability of the study's findings.

Rating Explanation

This is a large-scale, retrospective cohort study utilizing a robust national healthcare database, providing valuable insights into the risks associated with SARS-CoV-2 reinfection. While some limitations exist regarding generalizability and the evolving nature of the pandemic, the study's methodology and findings are strong, warranting a rating of 4.

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