Abstract: Objective To explore the impact of the number of COVID-19 infections on the severity of symptoms and quality of life. Methods From November to December 2023, patients infected with the novel coronavirus (COVID-19) were randomly selected through the Guangzhou 12320 Health Hotline platform. The quality of life and severity of the condition were assessed using the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) score. The number of COVID-19 infections and symptom severity were analyzed, and logistic regression was used to examine the relationship between the number of infections and CAT scores. Results Among the 2 809 COVID-19 patients, the average age was 37.10 ± 13.70 years, with a male-to-female ratio of 1.15:1. There were 1 184 cases (42.15%) with one infection, 1 248 cases (44.43%) with two infections, and 377 cases (13.42%) with three or more infections. Mild symptoms (CAT score≤20) were observed in 2 505 cases (89.18%), while severe symptoms (CAT score>20) were observed in 304 cases (10.82%). After adjusting for relevant factors using multivariate logistic regression, the results showed that two COVID-19 infections (OR=1.41, 95% CI: 1.07-1.86) and three or more infections (OR=2.39, 95% CI: 1.69-3.36) were risk factors for severe symptoms. Conclusions Repeated COVID-19 infections may significantly impact the severity of symptoms and quality of life in patients. Preventing reinfection with the COVID-19 is particularly important for the long-term health of residents.

Key words: Number of COVID-19 infections, Symptom severity, Quality of life, Chronic obstructive pulmonary disease assessment test (CAT Score), Reinfection