By Damian McNamara, MA

A disturbing finding that repeated Covid infections are linked to long Covid. One real limitation of the study is that the definition of long Covid is too brief to be optimal.

Also, this is a sample of veterans who may be less healthy than others, but at the same time may be more stoic and therefore visit physicians more rarely.  Even so, this line of research deserves follow-up since the Feds are pouring resources into the study of long Covid. 

If this finding holds up, the implications for national and global health are ominous.  At the same time, the value of researching integrative and functional medicine interventions is ever more important.

Michael Lerner

People who get reinfected with the virus that causes COVID-19 have more health risks with each round of reinfection, a large national database study reveals.

Researchers saw worse health effects during active infection, but some symptoms lasted as long as 6 months, suggesting a direct link between reinfection and long COVID.

“Reinfection adds or contributes additional health risks. It is not totally benign, and people should try to avoid getting reinfected,” says lead study author Ziyad Al-Aly, MD.

The risks remained whether or not people were fully vaccinated. In some cases, people might have been infected earlier with the Delta strain and now be exposed to Omicron or its subvariant, BA.5, which may be better at evading vaccine protection, he says.

“It is also possible that the first infection may have weakened some organ systems and made people more vulnerable to health risks when they get a second or a third infection,” adds Al-Aly, a clinical epidemiologist at Washington University and chief of research and development at the VA St. Louis Health Care System. “There are a lot of variables at play, but it is clear that reinfections contribute additional risks and they should be avoided.”

Al-Aly and his colleagues compared 257,427 people with a first infection with the virus that causes COVID-19 to a group of 38,926 people who had a second or later infection, and then to 5.4 million people who never were infected. The information for the study came from veterans in a Department of Veterans Affairs health care database.

The results were published online June 17 as a pre-print study, which means it has not yet been peer-reviewed, a key step to help evaluate and validate clinical research. The study is under review by the journal Nature Portfolio.

Experts Weigh In

Three COVID-19 experts who were not involved in the research raised a couple of caveats, including how a study of veterans might or might not apply to the general population.

“It’s the first study to characterize the risks of reinfection,” says Eric Topol, MD.

He points out that a second infection, compared to a first, was associated with twice the rate of people dying from any cause, as well as twice the risk of heart or lung problems.

The extra risks grew larger with each infection as well, says Topol, executive vice president of Scripps Research and editor-in-chief for Medscape, WebMD’s sister site for health care professionals.

“Obviously these findings are worrisome since reinfection was quite rare before the Omicron wave hit, at 1% or less through the Delta variant wave. But now reinfections have become much more common,” he says.

Higher Risks, Especially for Some

The study was “well done,” says Ali Mokdad, PhD, when asked to comment. Al-Aly and colleagues “have access to a good data, and they have done several studies.”

He says the extra risks are more likely among the elderly, the immunocompromised, and people with other medical conditions.

“It makes sense, and let me explain why,” Mokdad says. “When you have somebody who got COVID-19 the first time and was impacted by it, maybe someone who was older or who had a chronic condition, the next hit would also cause more damage.”

“That’s why you would expect some people would be more likely to have a harder second infection,” says Mokdad, an adjunct professor of epidemiology and professor of health metrics sciences at the University of Washington in Seattle.

“The best thing for you and for the general public – healthy or not, chronic condition or not – is not to get infected,” he says. “Go get your vaccines and your boosters, and wear a mask when you’re in a place that is crowded and you cannot keep a safe distance.”

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