Abstract
In this work, we develop and analyze a mathematical model for the dynamics of COVID-19 with re-infection in order to assess the impact of prior comorbidity (specifically, diabetes mellitus) on COVID-19 complications. The model is simulated using data relevant to the dynamics of the diseases in Lagos, Nigeria, making predictions for the attainment of peak periods in the presence or absence of comorbidity. The model is shown to undergo the phenomenon of backward bifurcation caused by the parameter accounting for increased susceptibility to COVID-19 infection by comorbid susceptibles as well as the rate of reinfection by those who have recovered from a previous COVID-19 infection. Simulations of the cumulative number of active cases (including those with comorbidity), at different reinfection rates, show infection peaks reducing with decreasing reinfection of those who have recovered from a previous COVID-19 infection. In addition, optimal control and cost-effectiveness analysis of the model reveal that the strategy that prevents COVID-19 infection by comorbid susceptibles is the most cost-effective of all the control strategies for the prevention of COVID-19.