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Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?

Although coronavirus disease 2019 (COVID-19) is regarded as an acute, resolving infection followed by the development of protective immunity, recent systematic literature review documents evidence for often highly prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in...

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Autores principales: Simmonds, Peter, Williams, Sarah, Harvala, Heli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Microbiology Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222868/
https://www.ncbi.nlm.nih.gov/pubmed/33331810
http://dx.doi.org/10.1099/jgv.0.001545
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author Simmonds, Peter
Williams, Sarah
Harvala, Heli
author_facet Simmonds, Peter
Williams, Sarah
Harvala, Heli
author_sort Simmonds, Peter
collection PubMed
description Although coronavirus disease 2019 (COVID-19) is regarded as an acute, resolving infection followed by the development of protective immunity, recent systematic literature review documents evidence for often highly prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory and faecal samples, periodic recurrence of PCR positivity in a substantial proportion of individuals and increasingly documented instances of reinfection associated with a lack of protective immunity. This pattern of infection is quite distinct from the acute/resolving nature of other human pathogenic respiratory viruses, such as influenza A virus and respiratory syncytial virus. Prolonged shedding of SARS-CoV-2 furthermore occurs irrespective of disease severity or development of virus-neutralizing antibodies. SARS-CoV-2 possesses an intensely structured RNA genome, an attribute shared with other human and veterinary coronaviruses and with other mammalian RNA viruses such as hepatitis C virus. These are capable of long-term persistence, possibly through poorly understood RNA structure-mediated effects on innate and adaptive host immune responses. The assumption that resolution of COVID-19 and the appearance of anti-SARS-CoV-2 IgG antibodies represents virus clearance and protection from reinfection, implicit for example in the susceptible–infected–recovered (SIR) model used for epidemic prediction, should be rigorously re-evaluated.
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spelling pubmed-82228682021-06-24 Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit? Simmonds, Peter Williams, Sarah Harvala, Heli J Gen Virol Insight Review Although coronavirus disease 2019 (COVID-19) is regarded as an acute, resolving infection followed by the development of protective immunity, recent systematic literature review documents evidence for often highly prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory and faecal samples, periodic recurrence of PCR positivity in a substantial proportion of individuals and increasingly documented instances of reinfection associated with a lack of protective immunity. This pattern of infection is quite distinct from the acute/resolving nature of other human pathogenic respiratory viruses, such as influenza A virus and respiratory syncytial virus. Prolonged shedding of SARS-CoV-2 furthermore occurs irrespective of disease severity or development of virus-neutralizing antibodies. SARS-CoV-2 possesses an intensely structured RNA genome, an attribute shared with other human and veterinary coronaviruses and with other mammalian RNA viruses such as hepatitis C virus. These are capable of long-term persistence, possibly through poorly understood RNA structure-mediated effects on innate and adaptive host immune responses. The assumption that resolution of COVID-19 and the appearance of anti-SARS-CoV-2 IgG antibodies represents virus clearance and protection from reinfection, implicit for example in the susceptible–infected–recovered (SIR) model used for epidemic prediction, should be rigorously re-evaluated. Microbiology Society 2020-12-17 /pmc/articles/PMC8222868/ /pubmed/33331810 http://dx.doi.org/10.1099/jgv.0.001545 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
spellingShingle Insight Review
Simmonds, Peter
Williams, Sarah
Harvala, Heli
Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title_full Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title_fullStr Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title_full_unstemmed Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title_short Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
title_sort understanding the outcomes of covid-19 – does the current model of an acute respiratory infection really fit?
topic Insight Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222868/
https://www.ncbi.nlm.nih.gov/pubmed/33331810
http://dx.doi.org/10.1099/jgv.0.001545
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