Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020

Background: As vaccine supply and access remain limited in many parts of the world, understanding the duration of protection from reinfection after natural infection is important. Methods: Distinct individuals testing positive and negative for SARS-CoV-2 between March 6, 2020, and August 31, 2020, i...

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Main Authors: Kevin B. Spicer, Connor Glick, Alyson M. Cavanaugh, Douglas Thoroughman
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:International Journal of Infectious Diseases
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971221008006
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author Kevin B. Spicer
Connor Glick
Alyson M. Cavanaugh
Douglas Thoroughman
author_facet Kevin B. Spicer
Connor Glick
Alyson M. Cavanaugh
Douglas Thoroughman
author_sort Kevin B. Spicer
collection DOAJ
description Background: As vaccine supply and access remain limited in many parts of the world, understanding the duration of protection from reinfection after natural infection is important. Methods: Distinct individuals testing positive and negative for SARS-CoV-2 between March 6, 2020, and August 31, 2020, in Kentucky, USA, were identified using the Kentucky National Electronic Disease Surveillance System. Individuals were followed for occurrence of a positive test for SARS-CoV-2 from 91 days after their initial test result through December 31, 2020. Protection from reinfection provided by a prior infection was calculated and additional analyses evaluated impact of age, sex, symptom status, long-term care facility connection, testing occurrence and frequency, and time from initial infection. Results: The protective effect from prior infection was 80.3% (95% CI, 78.2%–82.2%) for those aged 20–59 years and 67.4% (95% CI, 62.8%–71.4%) for those aged ≥60 years. At 30-day time periods through 270 days (with limited exceptions), protection was estimated to be >75% for those aged 20–59 years and >65% for those aged ≥60 years. Factors associated with repeat positive testing included a connection to a long-term care facility, duration of potential exposure, and absence of symptoms during initial infection. Conclusions: Natural infection provides substantial and persistent immunologic protection for a period of several months for most individuals, although subpopulations may be at greater risk of repeat positive testing and potential poor outcomes associated with reinfection. These subgroups include individuals aged ≥60 years, residents and staff of long-term care facilities, and those who have mild or asymptomatic illness with initial infection. Continued emphasis on vaccination and infection prevention and control strategies remains critically important in reducing the risk of reinfection and associated severe outcomes for these groups.
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spelling doaj.art-d7bbdcf9f7b74630b1808951795cc78d2022-12-21T18:45:10ZengElsevierInternational Journal of Infectious Diseases1201-97122022-01-011142128Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020Kevin B. Spicer0Connor Glick1Alyson M. Cavanaugh2Douglas Thoroughman3Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC), USA; Kentucky Department for Public Health, USA; Corresponding author: 275 E. Main St., Frankfort, KY, USAKentucky Department for Public Health, USAKentucky Department for Public Health, USA; Epidemic Intelligence Service, CDC, USAKentucky Department for Public Health, USA; Career Epidemiology Field Officer Program, Center for Preparedness and Response, CDC, USABackground: As vaccine supply and access remain limited in many parts of the world, understanding the duration of protection from reinfection after natural infection is important. Methods: Distinct individuals testing positive and negative for SARS-CoV-2 between March 6, 2020, and August 31, 2020, in Kentucky, USA, were identified using the Kentucky National Electronic Disease Surveillance System. Individuals were followed for occurrence of a positive test for SARS-CoV-2 from 91 days after their initial test result through December 31, 2020. Protection from reinfection provided by a prior infection was calculated and additional analyses evaluated impact of age, sex, symptom status, long-term care facility connection, testing occurrence and frequency, and time from initial infection. Results: The protective effect from prior infection was 80.3% (95% CI, 78.2%–82.2%) for those aged 20–59 years and 67.4% (95% CI, 62.8%–71.4%) for those aged ≥60 years. At 30-day time periods through 270 days (with limited exceptions), protection was estimated to be >75% for those aged 20–59 years and >65% for those aged ≥60 years. Factors associated with repeat positive testing included a connection to a long-term care facility, duration of potential exposure, and absence of symptoms during initial infection. Conclusions: Natural infection provides substantial and persistent immunologic protection for a period of several months for most individuals, although subpopulations may be at greater risk of repeat positive testing and potential poor outcomes associated with reinfection. These subgroups include individuals aged ≥60 years, residents and staff of long-term care facilities, and those who have mild or asymptomatic illness with initial infection. Continued emphasis on vaccination and infection prevention and control strategies remains critically important in reducing the risk of reinfection and associated severe outcomes for these groups.http://www.sciencedirect.com/science/article/pii/S1201971221008006SARS-CoV-2COVID-19protective immunity after natural infectionreinfectionCOVID-19 risk factors for reinfection
spellingShingle Kevin B. Spicer
Connor Glick
Alyson M. Cavanaugh
Douglas Thoroughman
Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
International Journal of Infectious Diseases
SARS-CoV-2
COVID-19
protective immunity after natural infection
reinfection
COVID-19 risk factors for reinfection
title Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
title_full Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
title_fullStr Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
title_full_unstemmed Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
title_short Protective Immunity after Natural Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) – Kentucky, USA, 2020
title_sort protective immunity after natural infection with severe acute respiratory syndrome coronavirus 2 sars cov 2 kentucky usa 2020
topic SARS-CoV-2
COVID-19
protective immunity after natural infection
reinfection
COVID-19 risk factors for reinfection
url http://www.sciencedirect.com/science/article/pii/S1201971221008006
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