Long COVID is a persistent health condition that can develop after an initial COVID-19 infection, characterized by symptoms lasting weeks, months, or even years. Reinfection refers to contracting the SARS-CoV-2 virus multiple times. This article explores the effects of reinfection on existing Long COVID, the likelihood of developing new Long COVID after subsequent infections, strategies for preventing reinfection, and approaches for managing symptoms that emerge or worsen after a new infection.
Impact of Reinfection on Existing Long COVID
Subsequent COVID-19 infections can significantly affect individuals already experiencing Long COVID. Reinfection often exacerbates existing symptoms, leading to relapses or the emergence of new health issues. A survey indicated that people with two COVID-19 infections were over twice as likely, and those with three or more infections nearly four times as likely, to report Long COVID compared to those with a single infection.
This worsening of symptoms can manifest as increased fatigue, a common symptom of Long COVID. The severity of fatigue has been shown to increase with reinfections, impacting daily activities and functional limitations. Individuals may also experience a resurgence of cognitive dysfunction, often called “brain fog,” and post-exertional malaise (PEM), where symptoms intensify after even minor physical or mental exertion.
Relapses triggered by reinfection can force individuals to take extended time off work or reduce their activity levels, impacting their quality of life. The cumulative risk of Long COVID increases proportionally with the number of SARS-CoV-2 infections, particularly in older individuals.
Risk of New Long COVID After Reinfection
While reinfection can worsen existing Long COVID, it also carries a risk of developing new Long COVID in individuals who did not experience it after their initial infection. Some research suggests that even mild or asymptomatic reinfections can lead to Long COVID. The probability of developing new Long COVID after reinfection varies and is influenced by several factors.
A study tracking US veterans found that reinfection increased the risk of Long COVID symptoms across multiple organ systems, with adverse health effects compounding with each subsequent infection, indicating a cumulative effect. Conversely, some studies suggest that the risk of new-onset Long COVID after a second infection might be lower than after a first infection, though the absolute risk remains present.
Factors influencing this risk include the severity of the reinfection and vaccination status. Even in vaccinated individuals, there is an increased risk of Long COVID after SARS-CoV-2 reinfection. However, vaccination before contracting COVID-19 has been shown to reduce the risk of developing Long COVID. The efficacy of vaccines in preventing Long COVID may be diminished by reinfections.
Preventing COVID-19 Reinfection
Implementing preventive measures is important for reducing the risk of COVID-19 reinfection, particularly for individuals concerned about Long COVID. Staying current with vaccinations is a primary strategy, as vaccines stimulate the immune system to build protection against the virus and can reduce the risk or lessen the severity of subsequent infections. Updated bivalent vaccines are especially recommended as they are designed to protect against currently circulating variants.
Other key preventive measures include:
- Consistent use of high-quality masks, such as N95 or KN95 respirators, in crowded indoor settings to reduce exposure to airborne viral particles.
- Improving indoor air ventilation through measures like opening windows or using air purifiers to disperse viral aerosols.
- Regular hand hygiene, involving frequent washing with soap and water or using an alcohol-based hand sanitizer, as a barrier against transmission.
- Strategic testing when symptoms appear to help in early identification and isolation, preventing further spread.
Support for Long COVID Symptoms Post-Reinfection
When Long COVID symptoms arise or worsen after a reinfection, consulting healthcare professionals for diagnosis and personalized care is essential. There is currently no standardized medication regimen specifically for Long COVID relapses, so treatment often focuses on managing individual symptoms. One widely recommended strategy is pacing, an energy conservation technique that involves balancing rest and activities to avoid symptom exacerbation. This means planning daily activities, prioritizing tasks, and taking breaks before feeling completely exhausted to stay within one’s “energy envelope”.
Addressing specific symptoms is an important part of management. For fatigue, establishing consistent sleep routines, avoiding screens before bed, and limiting caffeine and alcohol can be beneficial. For cognitive issues like brain fog, cognitive behavioral therapy techniques can help. Physical activity should be modified, with some patients benefiting from symptom-titrated exercise, where activity levels are adjusted based on symptom response, often starting with seated or prone exercises to minimize post-exertional malaise. Support networks and patient communities can offer valuable emotional support and shared experiences for individuals navigating the challenges of Long COVID.