What Happens to Older Adults Who Get COVID-19 Multiple Times?

Common but not harmless

Four-plus years since the pandemic began and it’s still too soon to have any definitive answers about the dangers of getting COVID-19 multiple times, says Marc Sala, M.D., codirector of the Northwestern Medicine Comprehensive COVID-19 Center in Illinois. “The virus is novel enough that we need long-term data and a large population to know what the collateral effects are for having had COVID multiple times,” he says. “We just haven’t had the follow-up time for it.”

Although doctors and scientists are still trying to get a handle on the health consequences of getting reinfected, this much seems certain: There is no such thing as risk-free COVID-19. That’s especially true for people who are more likely to experience severe symptoms.

A recent study published in the journal Communications Medicine suggests that older people, as well as people with weakened immune systems and those who experienced severe COVID-19 the first time around, are at a greater risk for a severe case if they’re reinfected.

Less certain? Whether multiple bouts of COVID-19 raise your chances of experiencing what’s known as long COVID — the persistence of symptoms such as fatigue, fever, cough and difficulty concentrating that last for at least three months postinfection.  

A study published in 2022 in Nature Medicine found that people who got COVID-19 at least twice were more than three times as likely to develop short-term and long-term health effects, including lung and heart issues, and over 1.5 times as likely to have a neurological disorder, including brain fog and strokes, compared to those who were infected once.

“While we know that vaccines are protective from most complications from COVID, especially the very severe ones, it’s not quite perfect when it comes to long COVID,” Sala says. “We have some data that suggest that the higher number of infections puts you at greater risk of having long COVID at some point. But even that isn’t always consistent.”  

How to avoid reinfection

You might think COVID-19 takes a break in the summer — like many other common respiratory viruses — but that’s not true. Unlike the flu, which comes on strong in the winter and disappears during the summer, COVID never leaves, Schaffner says.

Although the usual tendency is to spend more time outdoors during summer months, which reduces the risk of infection, record-breaking temperatures mean people are finding relief indoors. “That provides opportunities for these COVID variants to spread because they’re very contagious,” Schaffner says. “The variants tend to produce milder disease, but high-risk groups are more likely to develop serious disease even if they get infected with these omicron variants.”

What to do? The usual: Stay up to date with vaccines, use common sense precautions like masking up when you’re in crowded spaces, test as soon as possible if you experience symptoms, and use antiviral medications like Paxlovid if you do test positive, since controlling the virus as quickly as possible can help reduce any long-term or lingering effects.

These measures are especially important for people 50-plus and those with medical conditions like heart disease, obesity, diabetes or chronic lung disease, the Centers for Disease Control and Prevention says.

“What we have to remember is that COVID has not gone away; it’s still with us,” Schaffner says. “Older people who get infected are more apt to get severe COVID, and there is a tendency for long COVID to develop more frequently after severe disease — all the more reason for us to be prudent when we know COVID is out there circulating.”