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COVID-19: Brief Communication
Clinical severity according to the primary infection variant in patients with suspected SARS-CoV-2 reinfection in Korea
Myung-Jae Hwang, Insob Hwang, Chungmin Park, Hanul Park, Taejong Son, Jong-Hun Kim
Epidemiol Health. 2023;45:e2023007.   Published online December 21, 2022
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AbstractAbstract AbstractSummary PDF
We aimed to evaluate the severity of suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection according to variants of concern in Gyeongsangbuk-do and Daegu, Korea.
The database of coronavirus disease 2019 (COVID-19) cases reported from epidemiological investigations through the integrated system operated by the Korea Disease Control and Prevention Agency, from January 20, 2020 to May 7, 2022 was combined with data from the Health Insurance Review and Assessment Service system. The severity odds ratio (SOR) in secondary infection episodes compared with primary infection was estimated using a generalized linear model with a binomial distribution.
In all patients, the SOR of SARS-CoV-2 reinfection was 0.89 (95% confidence interval [CI], 0.82 to 0.95), and the severity was lower than in the first infection. Patients who had been vaccinated within 91 days showed a more attenuated SOR (0.85; 95% CI, 0.74 to 0.98). However, despite vaccination, in patients with both primary and secondary infections caused by the Omicron variant, the severity was reduced to a lesser extent than in patients primarily infected with other variants.
We could make efforts to relieve the severity of COVID-19 in vulnerable populations, in which death is more likely, by recommending booster vaccinations in case of a resurgence.
Korean summary
국내 COVID-19 확진자들의 중증도 증가 위험은 재감염(2차감염) 시 감소하였지만, 1차감염과 재감염 모두 오미크론론 변이가 우세하였던 시기인 경우에는 오히려 증가하였다. 특히 마지막 예방접종일로부터 91일 이상인 확진자들과 60세이상 인구에서는 중증도 증가 위험이 더 높았다. 우리는 COVID-19가 장기화됨에 따라 취약인구집단에 대해 추가 예방접종을 권고함으로써 재감염시 중증도가 증가하는 것을 예방해야 할 필요가 있다.
Key Message
As COVID-19 prolongs, there is a need to recommend booster vaccinations for vulnerable populations to prevent the potential for increased severity in the event of reinfection.


Citations to this article as recorded by  
  • Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
    Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • The effect of shortening the quarantine period and lifting the indoor mask mandate on the spread of COVID-19: a mathematical modeling approach
    Jung Eun Kim, Heejin Choi, Minji Lee, Chang Hyeong Lee
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Previous infection with seasonal coronaviruses does not protect male Syrian hamsters from challenge with SARS-CoV-2
    Magen E. Francis, Ethan B. Jansen, Anthony Yourkowski, Alaa Selim, Cynthia L. Swan, Brian K. MacPhee, Brittany Thivierge, Rachelle Buchanan, Kerry J. Lavender, Joseph Darbellay, Matthew B. Rogers, Jocelyne Lew, Volker Gerdts, Darryl Falzarano, Danuta M. S
    Nature Communications.2023;[Epub]     CrossRef

Epidemiol Health : Epidemiology and Health