FAQ: Long COVID and COVID-19 Reinfection

15 March, 2024

How does my risk of long COVID change after more COVID-19 infections? 

There is little evidence available about the risk of post-acute sequelae of COVID-19 (PASC or long COVID) with regard to COVID-19 reinfection. This is largely because reinfection was substantially less common during the pre-Omicron era, and PASC outcomes appeared to be less common on an epidemiological level after Omicron (compared to pre-Omicron) infection (Fernández-de-las-Peñas, December 2022). However, an analysis of adults 50 years and older identified that PASC outcomes were more common in individuals with Omicron reinfections, compared to Omicron primary infections. This finding was supported by a recent report from the National COVID-19 Cohort Collaborative, which identified an increased risk of PASC after Omicron BA reinfection compared to Omicron BA primary infection. Additionally, the absolute number of PASC outcomes has risen substantially in the Omicron era due to much higher numbers of infections, compared to the pre-Omicron era (Boufidou, August 2023). As reinfections continue to occur in the Omicron era, clinicians and patients should be aware of the potential risk of PASC outcomes after COVID-19 reinfection.

Research also suggests that individuals with PASC outcomes after a primary COVID-19 infection may have reduced levels of neutralizing antibody, compared to individuals without PASC outcomes after their primary infection (Su, March 2022). This could predispose some individuals with a history of PASC to reinfection.

Plain Language Summary

It is challenging to study long COVID and repeat infections, especially since repeat infections were not common before Omicron became the dominant COVID-19 strain in late December 2021. However, research shows that repeat infections increase the risk of long COVID and could increase the severity of some long COVID symptoms in older adults. This is true even if they were fully vaccinated.

Research suggests that some people with long COVID might also have reduced levels of antibody after COVID-19 (compared to people without long COVID) which might increase their risk of reinfection.  

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