Associations between the number of self-reported SARS-CoV-2 infections and the diagnosis of new health conditions among adults in Canada, January 2020–June 2023c

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Background: Preexisting health conditions increase the risk of severe outcomes after SARS-CoV-2 infection.Emerging evidence suggests this relationship may be bi-directional with infection potentially increasing the risk of new health condition diagnoses.Objective: To examine the association between number of SARS-CoV-2 infections and the subsequent diagnosis of new health conditions, excluding longer-term symptoms after SARS-CoV-2 infection, and to examine associations between infection and vaccination characteristics, including longer-term symptoms, and new diagnoses among the infected.Methods: Population-based self-report cross-sectional survey data with longitudinal follow-up collected from Canadian adults was used to examine new diagnoses of 21 health conditions (and combinations thereof) since the first SARS-CoV-2 infection or, for uninfected adults, since the start of the pandemic.Multivariable binomial logistic regression was used to estimate adjusted odds ratios (aOR) controlling for sex, age, education, income, obesity, smoking status, preexisting health conditions and time at risk.Results: Relative to adults reporting no SARS-CoV-2 infections, those reporting two or more had significantly greater odds of being diagnosed with a new condition (aOR=1.76,95% confidence interval [CI]: 1.12-2.76,p=0.0133), respiratory condition (aOR=5.03,95% CI: 1.72-14.73,p=0.0114), and back problems (aOR=3.79,95% CI: 1.12-12.89,p=0.0056).Among infected adults, acute symptoms that limited daily life during the first infection (aOR=1.63,95% CI: 1.08-2.48,p=0.0206) and longer-term symptoms (aOR=3.35,95% CI: 2.24-5.03,p<0.0001) were also associated with being diagnosed with a new condition.Conclusion: Repeated SARS-CoV-2 infections may increase the risk of reporting newly diagnosed health conditions.Findings regarding acute infection severity and longer-term symptoms should be interpreted cautiously.Both of these factors may have increased care seeking and opportunities for diagnoses and may be the consequence of a new health condition (reverse causation).

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