From the Guidelines
Having multiple COVID-19 infections can significantly increase the risk of developing medical complications later in life, particularly cardiovascular problems, due to cumulative damage from repeated viral exposure and immune system dysregulation. According to the most recent and highest quality study, 1, long COVID is associated with multiple adverse outcomes, including new-onset conditions such as cardiovascular, thrombotic, and cerebrovascular disease, type 2 diabetes, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The study suggests that symptoms can last for years and may be lifelong, especially in cases of new-onset ME/CFS and dysautonomia.
Key factors that influence the risk of long-term complications include:
- The severity of initial infections
- Underlying health conditions
- Vaccination status
- Age
- Socio-economic factors, such as lower income and inability to rest during the early weeks after developing COVID-19
The mechanisms behind long COVID are complex and multifactorial, involving immune dysregulation, persisting reservoirs of SARS-CoV-2 in tissues, and autoimmunity, among others 1. The study highlights the need for further research to understand the pathogenesis of long COVID and to develop effective treatments.
In terms of preventive measures, staying current with COVID-19 vaccinations, practicing good hygiene, and following public health guidelines are crucial for reducing both infection risk and potential long-term complications. Additionally, early recognition and management of COVID-19 infections, as well as addressing underlying health conditions, can help mitigate the risk of long-term complications. As noted in 1, COVID-19 can confer significant cardiovascular morbidity and mortality, and long-term cardiovascular sequelae may include chest pain, palpitations, and cardiomyopathy.
Overall, the evidence suggests that having multiple COVID-19 infections can have serious consequences for one's health, and it is essential to take preventive measures to reduce the risk of infection and potential long-term complications.
From the Research
Medical Complications of COVID-19 Reinfection
- The risk of severe COVID-19 and poor outcomes after SARS-CoV-2 reinfection is still uncertain, but current studies suggest that reinfection does not contribute to extra risk of hospitalization, ICU, or death 2.
- A meta-analysis of 19 studies involving 34,375 cases of SARS-CoV-2 reinfection and 5,264,720 cases of SARS-CoV-2 primary infection found that reinfection cases were more likely to present with mild illness, and the risk of severe illness was reduced by 86% compared to primary infection cases 2.
- Primary infection provided some protection against reinfection and reduces the risk of symptomatic infection and severe illness 2.
Long-term Effects of COVID-19 Infection
- There is limited research on the long-term effects of COVID-19 infection, but some studies suggest that the use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may have a protective effect against severe COVID-19 infection 3, 4, 5, 6.
- However, the evidence is not conclusive, and further research is needed to explore the long-term effects of these medications and observe whether they are truly beneficial or not in reducing the severity of COVID-19 infections 3.
Risk Factors for Severe COVID-19 Infection
- Potential risk factors for severe COVID-19 infection include hypertension, cardiovascular disease, and chronic kidney disease, as well as the medications commonly prescribed for these conditions, ACE inhibitors, and Ang II receptor blockers 4, 5, 6.
- However, the use of ACE inhibitors and ARBs has been found to reduce the risk of hospitalization and mortality in some studies, and is not associated with an increased risk of acute kidney injury, macrovascular thrombosis, or in-hospital mortality 5, 6.