6 ms·

The effects are also compounding with each re-infection.

by musha68k 4y ago

haggy102 4y ago
Source?
- stevenrj 4y ago
  https://www.researchsquare.com/article/rs-1749502/v1 https://www.researchsquare.com/article/rs-1749502/v1
  - EGreg 4y ago
    "However, whether reinfection adds to the risk incurred after the first infection is not clear."
    - nishs 4y ago
      The sentence you’ve quoted, from the abstract of the paper, refers to the state of knowledge before this paper was written/published. The results section of the paper updates this knowledge. It says: “Compared to those with first infection, those with reinfection exhibited increased risk and excess burden of all-cause mortality, hospitalization, and at least one sequela in the acute phase and the post-acute phase of the reinfection.” “… the risk was higher in those who had two infections (HR 2.11 (2.07, 2.15); burden 234.58 (227.08, 241.92)), and highest in those with three or more infections (HR 3.00 (2.71, 3.31) …”
      - hackerlight 4y ago
        Hate to be that guy, but people who are susceptible to reinfection are also probably less healthy.
        bee_rider 4y ago
        I'm pretty sure everyone is susceptible to reinfection after a while.
        epgui 4y ago
        Affirmative. (biochemist)
        hackerlight 4y ago
        Susceptibility is also a spectrum, though, which is what I meant to get at and failed to communicate clearly. Immunocompromised people are probably more susceptible than others? I don't have data on that, it's just a guess.
        deleted 4y ago
        [deleted]
- qbasic_forever 4y ago
  https://erictopol.substack.com/p/a-reinfection-red-flag https://erictopol.substack.com/p/a-reinfection-red-flag Preprint of a major study from VA data. It will probably publish in the near future and I haven't heard any major changes or revisions.
  - timr 4y ago
    This study is one of a number of different ones from the same lab (Al Aly), taking a dataset of older, sicker people (US veterans who seek hospital care at the VA), and looking at groups who had two hospital confirmed infections, vs. those with one hospital confirmed infection, vs those who went to the hospital with no confirmed infections. Per the paper's abstract: > We show that COMPARED TO PEOPLE WITH FIRST INFECTION, reinfection contributes additional risks of all-cause mortality, hospitalization, and adverse health outcomes (emphasis mine) All this paper shows is that if you follow a cohort of older, sicker people -- people who are seeking hospital care! people who were infected and possibly hospitalized in the first wave! -- long enough for them to get multiple reinfections (in this case, about 2 years, from the original Covid wave through the Omicron wave), the overall rates of a (selected) set of different health conditions goes up over time. They have not shown that the increased risk is because of Covid. The paper has no way of following the younger, healthier people (particularly in the later waves, where home testing was common) who never set foot in a VA hospital and had a Covid test, despite having Covid. There is a huge selection bias [1] problem here. There may be others, such as immortal time bias. [2] What you would like to see in a study like this is that it is prospective (the participants were selected randomly in advance and followed over time); but this study is retrospective. You would also like to see a control against a similar illness, such as flu or non-Covid pneumonia; this study does not have such a comparison (despite being trivial to make), and resorts to using "atopic dermatitis and neoplasms" as a "negative control" instead. As an aside, Al Aly has a history of using a weird grab-bag of negative control illnesses against this same dataset across his various papers. One wonders why he doesn't always use the same illness as a negative control -- presumably atopic dermatitis didn't suddenly start being unassociated with Covid between his studies, right? Would the results not be the same if he was consistent? I'm guessing not. In short, this study is confounded, and Eric Topol really needs to tone down his fear-mongering. Even if you believe the top-line results, unless you are an elderly person sick enough to be seeking regular hospital care, this has very little relevance to your risk profile. [1] https://catalogofbias.org/biases/selection-bias/ https://catalogofbias.org/biases/selection-bias/ [2] https://catalogofbias.org/biases/immortal-time-bias/ https://catalogofbias.org/biases/immortal-time-bias/
ArboriaInstitut 4y ago
Do any of the epidemiologists/virologists who are saying this offer any thoughts as to why SARS-CoV-2 and the immune response to it are so different from every other novel virus which has emerged in the past? Is there any precedent at all for "a virus which reinfects you over and over with no reduction in lethality/sequelae from the repeat infections"?
- resoluteteeth 4y ago
  What if these sequalae aren't different from other coronaviruses?
  - ArboriaInstitut 4y ago
    Then obviously something else would have to be the main cause of the bump in excess deaths that's been observed.
    - eastbound 4y ago
      Lockdowns. It’s the only coronavirus we’ve treated by asking everyone to stay home. The impact on being healthy (sports, sun exposure, happiness) is huge.
- sandworm101 4y ago
  Yes. Flu. Constant (yearly) reinfection by slightly different variants with near-similar mortality regardless of previous variant exposure.
- ajross 4y ago
  > so different from every other novel virus which has emerged in the past There's only one novel pandemic to study every century or so. I don't think there's any evidence at all that it's "so different". It's just better studied because in 1918 only a handful of scientists even knew that "viruses" existed.
  - ArboriaInstitut 4y ago
noduerme 4y ago
Has there been anything published yet as to whether this holds true controlling for which strain of covid one is reinfected with, or whether one is vaccinated? I know at least one vaccinated person who's been reinfected with no symptoms at all the second time, and only knew because they had to get tested.

The effects are also compounding with each re-infection.

haggy102 4y ago

Source?

stevenrj 4y ago
https://www.researchsquare.com/article/rs-1749502/v1 https://www.researchsquare.com/article/rs-1749502/v1
- EGreg 4y ago
  "However, whether reinfection adds to the risk incurred after the first infection is not clear."
  - nishs 4y ago
    The sentence you’ve quoted, from the abstract of the paper, refers to the state of knowledge before this paper was written/published. The results section of the paper updates this knowledge. It says: “Compared to those with first infection, those with reinfection exhibited increased risk and excess burden of all-cause mortality, hospitalization, and at least one sequela in the acute phase and the post-acute phase of the reinfection.” “… the risk was higher in those who had two infections (HR 2.11 (2.07, 2.15); burden 234.58 (227.08, 241.92)), and highest in those with three or more infections (HR 3.00 (2.71, 3.31) …”
    - hackerlight 4y ago
      Hate to be that guy, but people who are susceptible to reinfection are also probably less healthy.
      - bee_rider 4y ago
        I'm pretty sure everyone is susceptible to reinfection after a while.
        epgui 4y ago
        Affirmative. (biochemist)
        hackerlight 4y ago
        Susceptibility is also a spectrum, though, which is what I meant to get at and failed to communicate clearly. Immunocompromised people are probably more susceptible than others? I don't have data on that, it's just a guess.
      - deleted 4y ago
        [deleted]
qbasic_forever 4y ago
https://erictopol.substack.com/p/a-reinfection-red-flag https://erictopol.substack.com/p/a-reinfection-red-flag Preprint of a major study from VA data. It will probably publish in the near future and I haven't heard any major changes or revisions.
- timr 4y ago
  This study is one of a number of different ones from the same lab (Al Aly), taking a dataset of older, sicker people (US veterans who seek hospital care at the VA), and looking at groups who had two hospital confirmed infections, vs. those with one hospital confirmed infection, vs those who went to the hospital with no confirmed infections. Per the paper's abstract: > We show that COMPARED TO PEOPLE WITH FIRST INFECTION, reinfection contributes additional risks of all-cause mortality, hospitalization, and adverse health outcomes (emphasis mine) All this paper shows is that if you follow a cohort of older, sicker people -- people who are seeking hospital care! people who were infected and possibly hospitalized in the first wave! -- long enough for them to get multiple reinfections (in this case, about 2 years, from the original Covid wave through the Omicron wave), the overall rates of a (selected) set of different health conditions goes up over time. They have not shown that the increased risk is because of Covid. The paper has no way of following the younger, healthier people (particularly in the later waves, where home testing was common) who never set foot in a VA hospital and had a Covid test, despite having Covid. There is a huge selection bias [1] problem here. There may be others, such as immortal time bias. [2] What you would like to see in a study like this is that it is prospective (the participants were selected randomly in advance and followed over time); but this study is retrospective. You would also like to see a control against a similar illness, such as flu or non-Covid pneumonia; this study does not have such a comparison (despite being trivial to make), and resorts to using "atopic dermatitis and neoplasms" as a "negative control" instead. As an aside, Al Aly has a history of using a weird grab-bag of negative control illnesses against this same dataset across his various papers. One wonders why he doesn't always use the same illness as a negative control -- presumably atopic dermatitis didn't suddenly start being unassociated with Covid between his studies, right? Would the results not be the same if he was consistent? I'm guessing not. In short, this study is confounded, and Eric Topol really needs to tone down his fear-mongering. Even if you believe the top-line results, unless you are an elderly person sick enough to be seeking regular hospital care, this has very little relevance to your risk profile. [1] https://catalogofbias.org/biases/selection-bias/ https://catalogofbias.org/biases/selection-bias/ [2] https://catalogofbias.org/biases/immortal-time-bias/ https://catalogofbias.org/biases/immortal-time-bias/

ArboriaInstitut 4y ago

Do any of the epidemiologists/virologists who are saying this offer any thoughts as to why SARS-CoV-2 and the immune response to it are so different from every other novel virus which has emerged in the past? Is there any precedent at all for "a virus which reinfects you over and over with no reduction in lethality/sequelae from the repeat infections"?

resoluteteeth 4y ago
What if these sequalae aren't different from other coronaviruses?
- ArboriaInstitut 4y ago
  Then obviously something else would have to be the main cause of the bump in excess deaths that's been observed.
  - eastbound 4y ago
    Lockdowns. It’s the only coronavirus we’ve treated by asking everyone to stay home. The impact on being healthy (sports, sun exposure, happiness) is huge.
sandworm101 4y ago
Yes. Flu. Constant (yearly) reinfection by slightly different variants with near-similar mortality regardless of previous variant exposure.
ajross 4y ago
> so different from every other novel virus which has emerged in the past There's only one novel pandemic to study every century or so. I don't think there's any evidence at all that it's "so different". It's just better studied because in 1918 only a handful of scientists even knew that "viruses" existed.
- ArboriaInstitut 4y ago

noduerme 4y ago

Has there been anything published yet as to whether this holds true controlling for which strain of covid one is reinfected with, or whether one is vaccinated? I know at least one vaccinated person who's been reinfected with no symptoms at all the second time, and only knew because they had to get tested.