1887

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Volume 102, Issue 3

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

Abstract

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.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): coronavirus , COVID-19 , persistence , respiratory syncytial virus influenza A virus and SARS-CoV-2
Funding
This study was supported by the:
  • Wellcome Trust (Award WT103767MA)
    • Principle Award Recipient: PeterSimmonds
© 2021 The Authors
  • 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.
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2020-12-17
2024-04-24
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Understanding the outcomes of COVID-19 – does the current model of an acute respiratory infection really fit?
J. Gen. Virol. 102, 001545 (2021); https://doi.org/10.1099/jgv.0.001545
/content/journal/jgv/10.1099/jgv.0.001545
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