The REinfection in COVID‐19 Estimation of Risk (RECOVER) study: Reinfection and serology dynamics in a cohort of Canadian healthcare workers
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Abstract
Background
Understanding the immune response to natural infection by SARS‐CoV‐2 is key to pandemic management, especially in the current context of emerging variants. Uncertainty remains regarding the efficacy and duration of natural immunity against reinfection.
Methods
We conducted an observational prospective cohort study in Canadian healthcare workers (HCWs) with a history of PCR‐confirmed SARS‐CoV‐2 infection to (i) measure the average incidence rate of reinfection and (ii) describe the serological immune response to the primary infection.
Results
Our cohort comprised 569 HCWs; median duration of individual follow‐up was 371 days. We detected six cases of reinfection in absence of vaccination between August 21, 2020, and March 1, 2022, for a reinfection incidence rate of 4.0 per 100 person‐years. Median duration of seropositivity was 415 days in symptomatics at primary infection compared with 213 days in asymptomatics ( p < 0.0001). Other characteristics associated with prolonged seropositivity for IgG against the spike protein included age over 55 years, obesity, and non‐Caucasian ethnicity.
Conclusions
Among unvaccinated healthcare workers, reinfection with SARS‐CoV‐2 following a primary infection remained rare.
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SciScore for 10.1101/2022.02.10.22269967: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Consent was obtained at enrolment and reviewed at each quarterly visit. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Cell Line Authentication Authentication: IgG levels were detected using an in-house, validated ELISA test based on the RBD of the spike protein. Table 2: Resources
Software and Algorithms Sentences Resources Data was extracted from REDCap and exported into CSV/Microsoft Excel worksheets for initial management. REDCapsuggested: (REDCap, RRID:SCR_003445)Statistical analyses were performed with R version 4.1.2 and RStudio Version 2021.09.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Kaplan-Meier survival … SciScore for 10.1101/2022.02.10.22269967: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Consent was obtained at enrolment and reviewed at each quarterly visit. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Cell Line Authentication Authentication: IgG levels were detected using an in-house, validated ELISA test based on the RBD of the spike protein. Table 2: Resources
Software and Algorithms Sentences Resources Data was extracted from REDCap and exported into CSV/Microsoft Excel worksheets for initial management. REDCapsuggested: (REDCap, RRID:SCR_003445)Statistical analyses were performed with R version 4.1.2 and RStudio Version 2021.09.1. RStudiosuggested: (RStudio, RRID:SCR_000432)Kaplan-Meier survival analysis, Kaplan-Meier curves and Cox regression models were produced with the survival and ggplot2 R packages. ggplot2suggested: (ggplot2, RRID:SCR_014601)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study nevertheless has some limitations. First, we observed a very small number of reinfections, hence limiting statistical power. Specifically, we could not determine whether demographic and/or clinical individual characteristics were associated with an increased or decreased reinfection incidence rate. It is also likely that we missed cases of asymptomatic reinfections, since we did not systematically screen all participants with NP swabs on a regular basis (e.g., every 2 weeks). Participants were randomly swabbed only twice during the entire follow-up, which could allow for asymptomatic reinfections to remain undetected. Our measured reinfection incidence rate thus probably underestimates the true reinfection rate, especially if asymptomatic reinfections are PCR-positive for only a short time. Our study could not identify any case of confirmed reinfection by genetic comparison of viral strains, because material recovered in reinfection swabs was insufficient to allow genome sequencing. These low viral loads suggest that reinfected individuals may be less likely to transmit SARS-CoV-2 to susceptible individuals compared to naïve individuals who become infected [30], with the caveat that our study was conducted prior to the spread of the Omicron variant. Vaccines against SARS-CoV-2 became available to participants about 4 months after the initiation of our study. Since participant recruitment was not yet completed when vaccination started, time between enrolment and vacc...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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