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Is COVID-19 receiving ADE from other coronaviruses?
1College of Biological Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
Insights
Antibody-dependent enhancement (ADE) may explain why COVID-19 was more severe in Hubei, China. Prior coronavirus exposure could trigger ADE, leading to severe symptoms and deaths, potentially explaining the geographic limitation of critical cases.
Area of Science:
- Immunology
- Virology
- Epidemiology
Background:
- The COVID-19 pandemic presents a puzzling geographic disparity in case severity.
- The Hubei province, China, experienced a disproportionately high number of severe COVID-19 cases compared to other regions.
Purpose of the Study:
- To investigate the potential role of antibody-dependent enhancement (ADE) in the varied severity of COVID-19 cases.
- To explore if prior exposure to other coronaviruses could contribute to severe SARS-CoV-2 infections through ADE.
Main Methods:
- The study hypothesizes a mechanism involving ADE.
- Analysis of immune response modulation, inflammation, lymphopenia, and cytokine storm in severe cases.
- Consideration of the requirement for prior exposure to similar antigenic epitopes.
Main Results:
- Antibody-dependent enhancement (ADE) is proposed as a potential explanation for the observed differences in COVID-19 severity.
- ADE can alter immune responses, potentially causing sustained inflammation, lymphopenia, and cytokine storm.
- These effects align with documented symptoms in severe COVID-19 cases and fatalities.
Conclusions:
- Prior exposure to endemic coronaviruses may prime the immune system for ADE upon SARS-CoV-2 infection.
- ADE offers a plausible explanation for the geographic clustering of severe COVID-19 outcomes observed in Hubei.
- This immunological phenomenon warrants further investigation to understand COVID-19's varied clinical presentations.
Abstract:
One of the most perplexing questions regarding the current COVID-19 coronavirus epidemic is the discrepancy between the severity of cases observed in the Hubei province of China and those occurring elsewhere in the world. One possible answer is antibody dependent enhancement (ADE) of SARS-CoV-2 due to prior exposure to other coronaviruses. ADE modulates the immune response and can elicit sustained inflammation, lymphopenia, and/or cytokine storm, one or all of which have been documented in severe cases and deaths. ADE also requires prior exposure to similar antigenic epitopes, presumably circulating in local viruses, making it a possible explanation for the observed geographic limitation of severe cases and deaths.
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