Among 1,543 participants in the Arizona CoVHORT six-year longitudinal study, 700 reported Long COVID (LC) symptoms persisting 2–49 months post-infection. LC-positive individuals faced a 21% elevated risk of reinfection and were 3.2 times more likely to develop LC symptoms after a second infection compared to those without prior LC. Female sex (OR=2.3), Hispanic ethnicity (OR=1.5), BMI above 34.5 (OR=1.7), and more than two infections (OR=3.2) all independently increased LC odds. Vaccination before first infection cut LC likelihood by 51%—one of the stronger protective signals in the dataset.
This preprint, not yet peer-reviewed, adds meaningful texture to the growing LC literature by demonstrating a compounding-risk cycle: LC survivors are both more susceptible to reinfection and more likely to develop LC again, suggesting persistent immune dysregulation rather than simple viral persistence. The vaccination finding reinforces prior meta-analyses showing roughly 50% relative risk reduction, lending biological plausibility here. The Hispanic ethnicity association aligns with documented health-equity disparities in COVID outcomes broadly, pointing to structural as well as biological contributors. Critically, qualitative data reveal provider knowledge gaps as a real-world barrier—an underappreciated bottleneck. Limitations include self-reported symptoms, cross-sectional survey design within a longitudinal cohort, and potential healthy-volunteer bias. With 400 million people estimated affected globally, the compounding-risk finding, if confirmed after peer review, has substantial public-health implications for repeat-infection prevention strategies.