A follow-up study on the recovery and reinfection of Omicron COVID-19 patients in Shanghai, China

Mengna Lin; Kangli Cao; Feixiang Xu; Xueling Wu; Yao Shen; Su Lu; Zhongshu Kuang; Hailin Ding; Shuyun Yuan; Mian Shao; Guorong Gu; Lingyu Xing; Tianwen Gu; Shaodie Chen; Jian Sun; Jiamin Zhu; Xiaoyan Zhang; Yilin Yang; Guoping Zhao; Lihong Huang; Jianqing Xu; Zhenju Song

doi:10.1080/22221751.2023.2261559

A follow-up study on the recovery and reinfection of Omicron COVID-19 patients in Shanghai, China

Emerg Microbes Infect. 2023 Dec;12(2):2261559. doi: 10.1080/22221751.2023.2261559. Epub 2023 Oct 9.

Authors

Mengna Lin^{1

2}, Kangli Cao³, Feixiang Xu¹, Xueling Wu⁴, Yao Shen⁵, Su Lu¹, Zhongshu Kuang¹, Hailin Ding¹, Shuyun Yuan¹, Mian Shao¹, Guorong Gu¹, Lingyu Xing¹, Tianwen Gu¹, Shaodie Chen¹, Jian Sun¹, Jiamin Zhu¹, Xiaoyan Zhang³, Yilin Yang¹, Guoping Zhao^{6

7}, Lihong Huang⁸, Jianqing Xu^{3

2}, Zhenju Song^{1

2

9}

Affiliations

¹ Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
² Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, People's Republic of China.
³ Clinical Center for Bio-Therapy, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
⁴ Department of Respiratory Medicine, Renji hospital, Shanghai jiaotong University, School of medicine, 160 Pujian Road, Shanghai, China.
⁵ Department of Respiratory and Critical Care Medicine, Shanghai Pudong Hospital, Fudan University, Shanghai, People's Republic of China.
⁶ State Key Laboratory of Genetic Engineering, Fudan Microbiome Center, School of Life Sciences, Fudan University, Shanghai, People's Republic of China.
⁷ Bio-Med Big Data Center, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, People's Republic of China.
⁸ Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
⁹ Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai, People's Republic of China.

Abstract

Limited follow-up data is available on the recovery of Omicron COVID-19 patients after acute illness. It is also critical to understand persistence of neutralizing antibody (NAb) and of T-cell mediated immunity and the role of hybrid immunity in preventing SARS-CoV-2 reinfection. This prospective cohort study included Omicron COVID-19 individuals from April to June 2022 in Shanghai, China, during a large epidemic caused by the Omicron BA.2 variant. A total of 8945 patients from three medical centres were included in the follow up programme from November 2022 to February 2023. Of 6412 individuals enrolled for the long COVID analysis, 605 (9.4%) individuals experienced at least one sequelae, mainly had fatigue and mental symptoms specific to Omicron BA.2 infection compared with other common respiratory tract infections. During the second-visit, 548 (12.1%) cases of Omicron reinfection were identified. Hybrid immunity with full and booster vaccination had reduced risk of SARS-CoV-2 reinfection by 0.29-fold (95% CI: 0.63-0.81) and 0.23-fold (95% CI: 0.68-0.87), respectively. For 469 participants willing to the hospital during the first visit, those who received full (72 [IQR, 36-156]) or booster (64 [IQR, 28-132]) vaccination had significantly higher neutralizing antibody titers than those with incomplete vaccination (36 [IQR, 16-79]). Moreover, non-reinfection cases had higher neutralizing antibody titers (64 [IQR, 28-152]) compared to reinfection cases (32 [IQR, 20-69]).

Keywords: Long-COVID; T-cell responses; inactivated vaccination; neutralizing antibody; reinfection.

MeSH terms

Antibodies, Neutralizing
Antibodies, Viral
COVID-19*
China / epidemiology
Follow-Up Studies
Humans
Post-Acute COVID-19 Syndrome
Prospective Studies
Reinfection / epidemiology
SARS-CoV-2

Substances

Antibodies, Neutralizing
Antibodies, Viral

Grants and funding

This work was supported by the National Key Research and Development Program of China [grant numbers 2021YFC2501800, 2023YFC0872500], National Natural Science Foundation of China [grant numbers 82273733, 92169206], Science and Technology of Shanghai Committee [grant numbers 22YJ1400100, 21MC1930400, 20DZ2261200], Natural Science Foundation of Shanghai [grant number20Z11901004] and the "Leading Goose” R&D Program of Zhejiang Province (2023C03045). The funders had no role in study design, data collection and analysis, decision to publish or manuscript preparation.