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Published in: BMC Medicine 1/2021

Open Access 01-12-2021 | SARS-CoV-2 | Research article

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

Authors: Francesco Pinotti, Paul S. Wikramaratna, Uri Obolski, Robert S. Paton, Daniel S. C. Damineli, Luiz C. J. Alcantara, Marta Giovanetti, Sunetra Gupta, José Lourenço

Published in: BMC Medicine | Issue 1/2021

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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.
Appendix
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Metadata
Title
Potential impact of individual exposure histories to endemic human coronaviruses on age-dependent severity of COVID-19
Authors
Francesco Pinotti
Paul S. Wikramaratna
Uri Obolski
Robert S. Paton
Daniel S. C. Damineli
Luiz C. J. Alcantara
Marta Giovanetti
Sunetra Gupta
José Lourenço
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-020-01887-1

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