Over time, COVID-19 may become a childhood disease

The novel coronavirus may eventually reduce to just a youngsters' disease.

 Over time, COVID-19 may become a childhood disease

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• The story: Researchers have noted that in a scenario of long-lasting immunity, the young are predicted to have the highest rates of infection as older individuals are protected from new infections by prior infection. COVID-19 may behave like other common-cold coronaviruses in the next few years, affecting mostly young children who have not yet been vaccinated or exposed to the virus.
• Research indications: A US-Norwegian team noted that because COVID-19 severity is generally lower among children, the overall burden from this disease is expected to decline as the SARS-CoV-2 virus becomes endemic in the global population. Following infection by SARS-CoV-2, there has been a clear signature of increasingly severe outcomes and fatality with age. Yet, modelling results suggest that the risk of infection will likely shift to younger children as the adult community becomes immune either through vaccination or exposure to the virus.
• History's lesson: Historical records of respiratory diseases indicate that age-incidence patterns during virgin epidemics can be very different from endemic circulation. For example, ongoing genomic work suggests that the 1889-1890 pandemic, sometimes known as the Asiatic or Russian flu – which killed one million people, primarily adults over age 70 – may have been caused by the emergence of HCoV-OC43 virus, which is now an endemic, mild, repeat-infecting cold virus affecting mostly children ages 7-12 months old.
• Depends on immunity: If immunity to reinfection by SARS-CoV-2 wanes among adults, disease burden could remain high in that group, although previous exposure to the virus would lessen the severity of disease. Prior exposure may only confer short-term immunity to reinfection, allowing recurrent outbreaks, and this prior exposure may prime the immune system to provide some protection against severe disease. But research on COVID-19 shows that vaccination provides stronger protection than exposure to the SARS-CoV-2 virus, so everyone must get vaccinated.
• From start to finish: For many infectious respiratory diseases, prevalence in the population surges during a virgin epidemic but then recedes in a diminishing wave pattern as the spread of the infection unfolds over time toward an endemic equilibrium. Depending on immunity and demography, the model supports this observed trajectory. It predicts a strikingly different age-structure at the start of the COVID-19 epidemic compared to the eventual endemic situation. Researchers noted that in a scenario of long-lasting immunity, either permanent or at least 10 years, the young are predicted to have the highest rates of infection as older individuals are protected from new infections by prior infection.
• Summary: This prediction is likely to hold only if reinfections produce only mild disease. However, the burden of mortality over time may remain unchanged if primary infections do not prevent reinfections or mitigate severe disease among the elderly.

 

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