Medium-term scenarios of COVID-19 as a function of immune uncertainties and chronic disease
Medium-term scenarios of COVID-19 as a function of immune uncertainties and chronic disease
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DOI：
10.1098/rsif.2023.0247
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发表时间：
2023-08-30
影响因子：
3.9
通讯作者：
Grenfell, Bryan T.
中科院分区：
文献类型：
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作者：
Saad-Roy, Chadi M.;Morris, Sinead E.;Grenfell, Bryan T.
随着SARS-CoV-2的发展轨迹继续，COVID-19的长期免疫流行病学、长期COVID的动态以及逃逸变异的影响是重要的未决问题。我们用一个简单的模型框架来研究这些剩余的不确定性，该模型框架考虑了通过感染或疫苗接种的多种（抗原）暴露。如果免疫力（对感染或长期COVID）随着暴露的效价迅速积累，我们发现感染水平和长期COVID的负担在中期内显着降低。对宿主适应性免疫反应的更悲观假设表明，COVID-19的长期负担可能会在未来几年内增加。然而，我们还发现，这些结果可以通过最终引入引发强大（即持久的，传播阻断和/或“防进化”）免疫的疫苗来减轻。总体而言，我们的工作强调了仍然存在的广泛的未来情景，收集真实世界流行病学数据以确定可能结果的重要性，以及开发高效传播阻断，持久和广泛保护疫苗的迫切需要。
As the SARS-CoV-2 trajectory continues, the longer-term immuno-epidemiology of COVID-19, the dynamics of Long COVID, and the impact of escape variants are important outstanding questions. We examine these remaining uncertainties with a simple modelling framework that accounts for multiple (antigenic) exposures via infection or vaccination. If immunity (to infection or Long COVID) accumulates rapidly with the valency of exposure, we find that infection levels and the burden of Long COVID are markedly reduced in the medium term. More pessimistic assumptions on host adaptive immune responses illustrate that the longer-term burden of COVID-19 may be elevated for years to come. However, we also find that these outcomes could be mitigated by the eventual introduction of a vaccine eliciting robust (i.e. durable, transmission-blocking and/or 'evolution-proof') immunity. Overall, our work stresses the wide range of future scenarios that still remain, the importance of collecting real-world epidemiological data to identify likely outcomes, and the crucial need for the development of a highly effective transmission-blocking, durable and broadly protective vaccine.