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

Author(s)

Pinotti, Francesco ^[1] ; Wikramaratna, Paul S. ; Obolski, Uri ^{[2, 3]} ; Paton, Robert S. ^[1] ; Damineli, Daniel S. C. ^[4] ; Alcantara, Luiz C. J. ^{[5, 6]} ; Giovanetti, Marta ^{[5, 6]} ; Gupta, Sunetra ^[1] ; Lourenco, Jose ^[1]

Affiliation

^[1] Univ Oxford, Dept Zool, Oxford - England

^[2] Tel Aviv Univ, Sch Publ Hlth, Tel Aviv - Israel

^[3] Tel Aviv Univ, Porter Sch Environm & Earth Sci, Tel Aviv - Israel

^[4] Univ Sao Paulo, Dept Pediat, Fac Med, Sao Paulo - Brazil

^[5] Univ Fed Minas Gerais, Lab Genet Celular & Mol, Belo Horizonte, MG - Brazil

^[6] Inst Oswaldo Cruz Fiocruz, Lab Flavivirus, Rio De Janeiro - Brazil

• Document type: Journal article
• Source: BMC MEDICINE; v. 19, n. 1 JAN 12 2021.
• Web of Science Citations: 1

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. (AU)

• FAPESP's process: 19/23343-7 - Temporal analysis of gene expression
• Grantee: Daniel Santa Cruz Damineli
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 20/06160-3 - Human leukocyte transcriptional response to SARS-CoV-2 infection
• Grantee: Roberto Marcondes Cesar Junior
• Support Opportunities: Regular Research Grants