Evidence map›Paper›PMID 40576557›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

The Effect of SARS-CoV-2 Reinfection on Long-Term Symptoms in the Innovative Support for Patients With SARS-CoV-2 Infections Registry (INSPIRE).

John J Openshaw, Ji Chen, Robert Rodriguez, Michael Gottlieb, Kalyani McCullough, Michelle Santangelo, Mandy J Hill, Kristyn Gatling, Ahamed H Idris, Samuel McDonald and 13 more

Abstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

John J OpenshawDivision of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, USA.ORCID 0000-0002-3674-7187
Ji ChenCenter for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0009-0006-2851-3125
Robert RodriguezDepartment of Medicine, School of Medicine, University of California, Riverside, Riverside, California, USA.
Michael GottliebDepartment of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA.ORCID 0000-0003-3276-8375
Kalyani McCulloughCovid Control Branch, Division of Communicable Disease Control, California Department of Public Health, Richmond, California, USA.ORCID 0009-0005-6179-5075
Michelle SantangeloDepartment of Emergency Medicine, Rush University Medical Center, Chicago, Illinois, USA.ORCID 0000-0003-4353-0995
Mandy J HillDepartment of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, Texas, USA.
Kristyn GatlingDepartment of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA.ORCID 0009-0004-2294-1650
Ahamed H IdrisDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.ORCID 0000-0001-7113-6499
Samuel McDonaldDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Lauren E WiskDivision of General Internal Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, California, USA.ORCID 0000-0003-2932-4140
Jonathan DyalDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-5529-5377
Ralph C WangDepartment of Emergency Medicine, University of California, San Francisco, San Francisco, California, USA.ORCID 0000-0001-5382-9486
Kristin L RisingDepartment of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-3882-4956
Efrat KeanDepartment of Emergency Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Kelli N O'LaughlinDepartments of Emergency Medicine and Global Health, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-3027-1883
Kari A StephensDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
Caitlin MalickiDepartment of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0003-3436-6791
Zhenqiu LinCenter for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0002-3089-141X
Erica S SpatzCenter for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0002-1557-7713
Huihui YuCenter for Outcomes Research and Evaluation, Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0003-4019-3831
Robert A WeinsteinDepartment of Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA.ORCID 0000-0002-3390-858X
Joann ElmoreDivision of General Internal Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, California, USA.ORCID 0000-0002-7311-6835

Funding

CDC HHSNCIRD CDC HHS 75D30120C08008
6 · The paper itself

Abstract

backgroundThe clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.

methodsIndividuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue severity score ≥25) and the presence of organ system symptoms 3-6 months after the last infection.

resultsThe analysis included 886 individuals, 415 (46.8%) of whom experienced reinfection. For individuals who experienced their first infections in either the pre-Delta or Delta periods, the odds of having ≥3 symptoms 3-6 months after their most recent infection was lower in those reinfected than those with a single infection (weighted adjusted odds ratio, 0.45 [95% confidence interval, .21-.95] and 0.51 [.32-.79], respectively). However, in individuals reporting their first infection during the Omicron wave, the odds of reporting ≥3 symptoms after the most recent infection was higher in those reinfected than in those with a single infection (weighted adjusted odds ratio, 1.54 [95% confidence interval, 1.02-2.34]).

conclusionsThe timing of initial infection, reinfection, and the variants involved may play important roles in longer-term clinical outcomes. Repeated infection with Omicron variants may increase the risk of long-term symptoms.

Indexed as

COVID-19ReinfectionSARS-CoV-2AdultAgedFatigueFemaleHumansMaleMiddle AgedRegistriesCOVID-19long COVIDpost-COVID-19 syndromereinfectionSARS-CoV-2

Identifiers

PMID40576557
PMCPMC12497961

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.