Robin Monotti
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Jan 7, 2022: "Antibody-dependent enhancement of virus infection and disease: implications in COVID-19"

"Antibody-dependent enhancement (ADE) can be seen in a variety of viruses. It has a deleterious impact on antibody treatment of viral infection. This effect was first discovered in the dengue virus, and it has since been discovered in the coronavirus. Over 213 million people have been affected by the rapid spread of the newly emerging coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). The new coronavirus offers a significant threat and has sparked widespread concern. ADE in dengue virus and other viruses are discussed with possible effect on COVID-19 treatment and vaccine development will need to consider this phenomenon to ensure it is mitigated and avoided altogether. In these case scenarios, the role of ADE and its clinical consequences remains to be explored for this newly detected virus...

Recovered previously infected coronavirus disease 2019 (COVID-19) patients on infection with another strain are potentially susceptible to ADE. Currently, there are six known strains of SARS-CoV-2, namely, L-, S-, V-, G-, GH-, and GR-strain. The L strain was responsible for causing COVID-19 infections in Wuhan in December 2019. Other strains were subsequently detected; among these, the G strain is responsible for causing most widespread infections [16]. Therefore, if a candidate vaccine for SARS-CoV-2 is specific for any particular strain, then subsequent infection by other strain in the vaccinated person can potentially cause ADE. So, more studies are needed to focus on how the virus interacts with the host leading to the wide variance in observed symptoms and the apparent geographically based discrepancy. Should ADE be proven to be a mechanism of pathogenesis, both treatment regimens and vaccine development will need to consider this phenomenon to ensure it is mitigated and avoided altogether in the case of a vaccine. In these case scenarios, the role of ADE and its clinical consequences remains to be explored for this newly detected virus. Researchers must take note of what is known about ADE and coronaviruses and proceed with extreme caution in the development of the SARS-CoV-2 vaccine."

https://www.degruyter.com/document/doi/10.1515/jbcpp-2021-0264/html
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