Evidence map›Paper›PMID 34873592›Full record

Observational studyThe lancet. Healthy longevity2021

Reinfection with new variants of SARS-CoV-2 after natural infection: a prospective observational cohort in 13 care homes in England.

Anna Jeffery-Smith, Thomas A J Rowland, Monika Patel, Heather Whitaker, Nalini Iyanger, Sarah V Williams, Rebecca Giddings, Leah Thompson, Maria Zavala, Felicity Aiano and 9 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The lancet. Healthy longevity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 pooled it
3.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 62 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 1 institution in 1 country.

Anna Jeffery-SmithVirus Reference Department, Public Health England, London, UK.
Thomas A J RowlandVirus Reference Department, Public Health England, London, UK.
Monika PatelVirus Reference Department, Public Health England, London, UK.
Heather WhitakerData and Analytical Sciences, Public Health England, London, UK.
Nalini IyangerLondon Coronavirus Response Cell, National Infection Service, Public Health England, London, UK.
Sarah V WilliamsLondon Coronavirus Response Cell, National Infection Service, Public Health England, London, UK.
Rebecca GiddingsLondon Coronavirus Response Cell, National Infection Service, Public Health England, London, UK.
Leah ThompsonLondon Coronavirus Response Cell, National Infection Service, Public Health England, London, UK.
Maria ZavalaImmunisation and Countermeasures Division, Public Health England, London, UK.
Felicity AianoImmunisation and Countermeasures Division, Public Health England, London, UK.
Joanna EllisImmunisation and Countermeasures Division, Public Health England, London, UK.
Angie LackenbyVirus Reference Department, Public Health England, London, UK.
Katja HöschlerVirus Reference Department, Public Health England, London, UK.
Kevin BrownImmunisation and Countermeasures Division, Public Health England, London, UK.
Mary E RamsayImmunisation and Countermeasures Division, Public Health England, London, UK.
Robin GopalVirus Reference Department, Public Health England, London, UK.
J Yimmy ChowLondon Coronavirus Response Cell, National Infection Service, Public Health England, London, UK.
Shamez N LadhaniImmunisation and Countermeasures Division, Public Health England, London, UK.
Maria ZambonVirus Reference Department, Public Health England, London, UK.
Public Health England · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderstanding the duration of protection and risk of reinfection after natural infection is crucial to planning COVID-19 vaccination for at-risk groups, including care home residents, particularly with the emergence of more transmissible variants. We report on the duration, neutralising activity, and protection against the alpha variant of previous SARS-CoV-2 infection in care home residents and staff infected more than 6 months previously.

methodsWe did this prospective observational cohort surveillance in 13 care homes in Greater London, England. All staff and residents were included. Staff and residents had regular nose and throat screening for SARS-CoV-2 by RT-PCR according to national guidelines, with ad hoc testing of symptomatic individuals. From January, 2021, antigen lateral flow devices were also used, but positive tests still required RT-PCR confirmation. Staff members took the swab samples for themselves and the residents. The primary outcome was SARS-CoV-2 RT-PCR positive primary infection or reinfection in previously infected individuals, as determined by previous serological testing and screening or diagnostic RT-PCR results. Poisson regression and Cox proportional hazards models were used to estimate protective effectiveness of previous exposure. SARS-CoV-2 spike, nucleoprotein, and neutralising antibodies were assessed at multiple timepoints as part of the longitudinal follow-up.

findingsBetween April 10 and Aug 3, 2020, we recruited and tested 1625 individuals (933 staff and 692 residents). 248 participants were lost to follow-up (123 staff and 125 residents) and 1377 participants were included in the follow-up period to Jan 31, 2021 (810 staff and 567 residents). There were 23 reinfections (ten confirmed, eight probable, five possible) in 656 previously infected individuals (366 staff and 290 residents), compared with 165 primary infections in 721 susceptible individuals (444 staff and 277 residents). Those with confirmed reinfections had no or low neutralising antibody concentration before reinfection, with boosting of titres after reinfection. Kinetics of binding and neutralising antibodies were similar in older residents and younger staff.

interpretationSARS-CoV-2 reinfections were rare in older residents and younger staff. Protection from SARS-CoV-2 was sustained for longer than 9 months, including against the alpha variant. Reinfection was associated with no or low neutralising antibody before reinfection, but significant boosting occurred on reinfection.

fundingPublic Health England.

Indexed as

COVID-19SARS-CoV-2AgedAntibodies, NeutralizingCOVID-19 VaccinesHumansReinfectionAntibodies, NeutralizingCOVID-19 Vaccines

Identifiers

PMID34873592
PMCPMC8635459
OpenAlexW3216779618

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.