Epidemiologic Features of Recovery From SARS-CoV-2 Infection, 2024, Oelsner, Balte et al

Epidemiologic Features of Recovery From SARS-CoV-2 Infection
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820087


Findings In this cohort study of 4708 participants in a US meta-cohort, the median self-reported time to recovery from SARS-CoV-2 infection was 20 days, and an estimated 22.5% had not recovered by 90 days. Women and adults with suboptimal prepandemic health, particularly clinical cardiovascular disease, had longer times to recovery, whereas vaccination prior to infection and infection during the Omicron variant wave were associated with shorter times to recovery.

Results Of 4708 participants with self-reported SARS-CoV-2 infection (mean [SD] age, 61.3 [13.8] years; 2952 women [62.7%]), an estimated 22.5% (95% CI, 21.2%-23.7%) did not recover by 90 days post infection. Median (IQR) time to recovery was 20 (8-75) days. By 90 days post infection, there were significant differences in restricted mean recovery time according to sociodemographic, clinical, and lifestyle characteristics, particularly by acute infection severity (outpatient vs critical hospitalization, 32.9 days [95% CI, 31.9-33.9 days] vs 57.6 days [95% CI, 51.9-63.3 days]; log-rank P < .001). Recovery by 90 days post infection was associated with vaccination prior to infection (hazard ratio [HR], 1.30; 95% CI, 1.11-1.51) and infection during the sixth (Omicron variant) vs first wave (HR, 1.25; 95% CI, 1.06-1.49). These associations were mediated by reduced severity of acute infection (33.4% and 17.6%, respectively). Recovery was unfavorably associated with female sex (HR, 0.85; 95% CI, 0.79-0.92) and prepandemic clinical cardiovascular disease (HR, 0.84; 95% CI, 0.71-0.99). No significant multivariable-adjusted associations were observed for age, educational attainment, smoking history, obesity, diabetes, chronic kidney disease, asthma, chronic obstructive pulmonary disease, or elevated depressive symptoms. Results were similar for reinfections.

Conclusions and Relevance In this cohort study, more than 1 in 5 adults did not recover within 3 months of SARS-CoV-2 infection. Recovery within 3 months was less likely in women and those with preexisting cardiovascular disease and more likely in those with COVID-19 vaccination or infection during the Omicron variant wave.

 

"Results were similar for reinfections" suggests that every infection is another roll of the dice / pulling the trigger.

So the only known risk factors would be half the population and common health problems, but only by about 15%.

The main protective factor of vaccines appears to be reducing severity of acute illness, but it's not a sure thing, and their uptake will only go down with time.