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BMC Med . Potential impact of individual exposure histories to endemic human coronaviruses on age-dependent severity of COVID-19

tetano

Editor, Senior Moderator
BMC Med


. 2021 Jan 12;19(1):19.
doi: 10.1186/s12916-020-01887-1.
Potential impact of individual exposure histories to endemic human coronaviruses on age-dependent severity of COVID-19


Francesco Pinotti[SUP] 1 [/SUP], Paul S Wikramaratna[SUP] 2 [/SUP], Uri Obolski[SUP] 3 4 [/SUP], Robert S Paton[SUP] 5 [/SUP], Daniel S C Damineli[SUP] 6 [/SUP], Luiz C J Alcantara[SUP] 7 8 [/SUP], Marta Giovanetti[SUP] 7 8 [/SUP], Sunetra Gupta[SUP] 5 [/SUP], Jos? Louren?o[SUP] 5 [/SUP]



Affiliations

Abstract

Background: Cross-reactivity to SARS-CoV-2 from exposure to endemic human coronaviruses (eHCoV) is gaining increasing attention as a possible driver of both protection against infection and COVID-19 severity. Here we explore the potential role of cross-reactivity induced by eHCoVs on age-specific COVID-19 severity in a mathematical model of eHCoV and SARS-CoV-2 transmission.
Methods: We use an individual-based model, calibrated to prior knowledge of eHCoV dynamics, to fully track individual histories of exposure to eHCoVs. We also model the emergent dynamics of SARS-CoV-2 and the risk of hospitalisation upon infection.
Results: We hypothesise that primary exposure with any eHCoV confers temporary cross-protection against severe SARS-CoV-2 infection, while life-long re-exposure to the same eHCoV diminishes cross-protection, and increases the potential for disease severity. We show numerically that our proposed mechanism can explain age patterns of COVID-19 hospitalisation in EU/EEA countries and the UK. We further show that some of the observed variation in health care capacity and testing efforts is compatible with country-specific differences in hospitalisation rates under this model.
Conclusions: This study provides a "proof of possibility" for certain biological and epidemiological mechanisms that could potentially drive COVID-19-related variation across age groups. Our findings call for further research on the role of cross-reactivity to eHCoVs and highlight data interpretation challenges arising from health care capacity and SARS-CoV-2 testing.

Keywords: COVID-19; Cross-reactivity; Endemic coronaviruses; Immunopathology; Individual-based model; Infectious disease dynamics; Mathematical model; SARS-CoV-2.
 
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