Post-acute sequelae of hospitalised COVID-19 re-infection compared with hospitalised first-time infection: a population-based retrospective cohort study in Hong Kong.

• Tác giả: Esther Wai Yin Chan, Shirley Chiu Wai Chan, Celine S L Chui, Ivan F N Hung, Francisco T T Lai, Chak Sing Lau, Xue Li, Lung Yi Mak, Eric Yuk Fai Wan, Carlos Wong, Ian Chi-Kei Wong, Vincent Ka Chun Yan, Deliang Yang, Yin Zhang
• Ngôn ngữ: eng
• Ký hiệu phân loại: 785.13 *Trios
• Thông tin xuất bản: England : BMJ public health , 2025
• Bộ sưu tập: NCBI
• ID: 682655

Tóm tắt

 INTRODUCTION: COVID-19 infection is associated with post-acute adverse outcomes affecting multiple organ systems. Although preliminary studies have suggested that COVID-19 re-infection may have a cumulative effect on long-term outcome, differential effects of COVID-19 re-infection severe enough to be hospitalised on post-acute sequelae compared with hospitalised first-time infection have not been explored. METHODS: Retrospective cohort study using territory-wide electronic medical records databases in Hong Kong. Adults hospitalised with COVID-19 between 1 January and 30 November 2022, who survived the first 28 days after infection and was discharged, were categorised into re-infection and first-time infection groups. Individuals with reinfection were compared with those with first-time infection for all-cause mortality, all-cause hospital readmission, attendance to the emergency department and complications during the post-acute period using propensity-score-weighted Cox regression. Subgroup analyses were conducted by age (<
 65 and ≥65 years), sex, Charlson Comorbidity Index (0-4, ≥5), COVID-19 vaccination (0-1, 2+doses) and hospitalisation status of previous infection. RESULTS: 2244 patients with hospitalised COVID-19 re-infection and 58 894 patients with hospitalised first-time COVID-19 infection were included. After a median follow-up of 170 days, re-infection was associated with a significantly higher risk of post-acute all-cause mortality compared with first-time infection (adjusted HR (95% CI): 1.366 (1.166 to 1.600)
  incidence rate (95% CI): 7.3 (7.1 to 7.5) vs 4.6 (4.4 to 4.7) per 10 000 person-days), all-cause hospital readmission (1.297 (1.200 to 1.403)
  50.5 (49.8 to 51.1) vs 28.1 (27.8 to 28.5)), and attendance to emergency departments (1.307 (1.199 to 1.425)
  35.4 (34.8 to 35.9) vs 21.9 (21.6 to 22.2)). Findings were consistent across subgroups of age, sex, health status and vaccination status. A greater magnitude of increased risk was observed especially among those hospitalised during a previous infection. CONCLUSION: Among patients with COVID-19 infection requiring hospitalisation, COVID-19 re-infection was associated with increased post-acute mortality and morbidity compared with first-time infection. Further studies are warranted to delineate the effects on complications.