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Risk of Reinfection After Seroconversion to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Population-based Propensity-score Matched Cohort Study
Author(s) -
Antonio Leidi,
Flora Koegler,
Roxane Dumont,
Richard Dubos,
MaríaEugenia Zaballa,
Giovanni Piumatti,
Matteo Coen,
Amandine Berner,
Pauline Darbellay Farhoumand,
Pauline Vetter,
Nicolas Vuilleumier,
Laurent Kaiser,
Delphine S. Courvoisier,
Andrew S. Azman,
Idris Guessous,
Silvia Stringhini,
Sabine Yerly,
Manuel Schibler,
Aglaé Tardin,
Camille Genecand,
Hélène Baysson,
Prune Collombet,
David De Ridder,
Paola D’Ippolito,
Matilde D’asaro-Aglieri Rinella,
Yaron Dibner,
Nacira El Merjani,
Natalie Francioli,
Marion Frangville,
Kailing Marcus,
Chantal Martinez,
Natacha Noël,
Francesco Pennacchio,
Javier PerezSaez,
Dušan Petrović,
A. Picazio,
Alborz Pishkenari,
Jane Portier,
Caroline Pugin,
Barinjaka Rakotomiaramanana,
Aude Richard,
Lilas Salzmann-Bellard,
Stephanie Schrempft,
Zoé Waldmann,
Ania Wisniak,
Alioucha Davidovic,
Joséphine Duc,
Julie Guérin,
Fanny Lombard,
Ma Will,
Antoine Flahault,
Isabelle Arm Vernez,
Olivia Keiser,
Loan Mattera,
Magdalena Schellongova,
Isabella Eckerle,
Pierre Lescuyer,
Benjamin Meyer,
Géraldine Poulain,
François Chappuis,
Sylvie Welker,
Laurent Gétaz,
Mayssam Nehme,
Febronio Pardo,
Guillemette Violot,
Samia Hurst,
Philippe Matute,
Jean-Michel Maugey,
Didier Pittet,
Arnaud G. L’Huillier,
Klara M. PosfayBarbe,
JeanFrançois Pradeau,
Michel Tacchino,
Didier Trono
Publication year - 2021
Publication title -
clinical infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.44
H-Index - 336
eISSN - 1537-6591
pISSN - 1058-4838
DOI - 10.1093/cid/ciab495
Subject(s) - medicine , seroconversion , covid-19 , cohort , coronavirus , propensity score matching , cohort study , population , respiratory system , betacoronavirus , severe acute respiratory syndrome , virology , virus , outbreak , disease , environmental health , infectious disease (medical specialty)
Background Serological assays detecting anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies are being widely deployed in studies and clinical practice. However, the duration and effectiveness of the protection conferred by the immune response remains to be assessed in population-based samples. To estimate the incidence of newly acquired SARS-CoV-2 infections in seropositive individuals as compared to seronegative controls, we conducted a retrospective longitudinal matched study. Methods A seroprevalence survey including a representative sample of the population was conducted in Geneva, Switzerland, between April and June 2020, immediately after the first pandemic wave. Seropositive participants were matched one-to-two to seronegative controls, using a propensity-score including age, gender, immunodeficiency, body mass index (BMI), smoking status, and education level. Each individual was linked to a state-registry of SARS-CoV-2 infections. Our primary outcome was confirmed infections occurring from serological status assessment to the end of the second pandemic wave (January 2021). Results Among 8344 serosurvey participants, 498 seropositive individuals were selected and matched with 996 seronegative controls. After a mean follow-up of 35.6 (standard deviation [SD] 3.2) weeks, 7 out of 498 (1.4%) seropositive subjects had a positive SARS-CoV-2 test, of whom 5 (1.0%) were classified as reinfections. In contrast, the infection rate was higher in seronegative individuals (15.5%, 154/996) during a similar follow-up period (mean 34.7 [SD 3.2] weeks), corresponding to a 94% (95% confidence interval [CI]: 86%– 98%, P < .001) reduction in the hazard of having a positive SARS-CoV-2 test for seropositives. Conclusions Seroconversion after SARS-CoV-2 infection confers protection against reinfection lasting at least 8 months. These findings could help global health authorities establishing priority for vaccine allocation.

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