COVID-19 Reinfections in the City of São Paulo, Brazil: Prevalence and Socioeconomic Factors.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-04-16 eCollection Date: 2025-04-01 DOI:10.1093/ofid/ofaf181

Daniel Tavares Malheiro, Kauê Capellato Junqueira Parreira, Patricia Deffune Celeghini, Gustavo Yano Callado, André Luis Franco Cotia, Miguel Cendoroglo Neto, Marcelo A S Bragatte, Isaac Negretto Schrarstzhaupt, Vanderson Sampaio, Takaaki Kobayashi, Michael B Edmond, Alexandre R Marra

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引用次数: 0

Abstract

Background: Identifying those most susceptible to COVID-19 reinfection and understanding the associated characteristics is essential for developing effective prevention and control strategies. We aimed to evaluate the influence of social determinants, regional disparities, and variant evolution on COVID-19 reinfection rates.

Methods: We conducted a retrospective cohort study in São Paulo, Brazil, involving laboratory-confirmed COVID-19 patients. Reinfection was defined as a subsequent positive COVID-19 test at least 90 days after the previous confirmed infection. We assessed socioeconomic indicators, demographic factors, and spatial correlations. Reinfection rates were analyzed across different variants and subvariants.

Results: Among 73 741 patients, 5626 (7.6%) experienced reinfections, with most (95.0%) having 1 reinfection. Reinfection rates increased significantly during the Omicron period, particularly with subvariants BA.1, BA.2/BA.4, BA.5, and XBB/XBB.1.5/XBB.1.16. The highest rates were seen in patients initially infected during the BA.2/BA.4 and BA.5 periods, who were later reinfected by XBB subvariants. Socioeconomic indicators, including lower Human Development Index, higher proportions of informal settlements, and lower employment rates, were significantly associated with higher reinfection rates. Geospatial analysis showed significant clustering of reinfections in areas with higher social vulnerability.

Conclusions: COVID-19 reinfection rates were heavily influenced by socioeconomic disparities and variant-specific factors. Regions with lower Human Development Index and worse socioeconomic conditions experienced higher reinfection rates. These findings highlight the need for targeted public health interventions focused on vulnerable populations, particularly in areas with greater social inequality. As new variants continue to emerge, ongoing surveillance and adaptive public health strategies will be critical to reducing reinfections.

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巴西圣保罗市COVID-19再感染情况：流行情况和社会经济因素

背景：确定COVID-19再感染易感人群并了解相关特征对于制定有效的预防和控制策略至关重要。我们的目的是评估社会决定因素、地区差异和变异进化对COVID-19再感染率的影响。方法：我们在巴西圣保罗进行了一项回顾性队列研究，纳入了实验室确诊的COVID-19患者。再感染被定义为在上一次确诊感染后至少90天再次出现COVID-19检测阳性。我们评估了社会经济指标、人口因素和空间相关性。分析了不同变异和亚变异的再感染率。结果：73 741例患者中有5626例（7.6%）发生再感染，其中1次再感染占95.0%。再感染率在欧米克隆期间显著增加，尤其是BA.1、BA.2/BA亚变异体。4、BA.5和XBB/XBB.1.5/XBB.1.16。在BA.2/BA期间初次感染的患者发病率最高。4和BA.5期，后来再次感染XBB亚变体。社会经济指标，包括较低的人类发展指数、较高的非正规住区比例和较低的就业率，与较高的再感染率显著相关。地理空间分析显示，再感染在社会脆弱性较高的地区有显著聚集性。结论：社会经济差异和变异特异性因素对COVID-19再感染率影响较大。人类发展指数较低、社会经济条件较差的地区再感染率较高。这些调查结果突出表明，需要采取有针对性的公共卫生干预措施，重点关注弱势群体，特别是在社会不平等程度较高的地区。随着新的变异不断出现，持续监测和适应性公共卫生战略对于减少再感染至关重要。

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.