COVID-19: A MUCOSAL DISEASE

Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite.Emeritus Professor Robert Clancy AM

1. The Influenza Model: Pandemic Experience.

Covid-19 is an RNA virus infection of the respiratory mucosa with mechanisms and clinical characteristics similar to those of influenza. Both can occur in pandemics – currently it is Covid-19 that has our attention with 250 million documented infections and in excess of 5 million deaths. In 1918-1919 it was Spanish influenza (sub-type H1N1) that infected one third of the world (500 million) with a 10% mortality (compared to Covid’s 3% with 2% mortality). The Spanish flu swept the world in three waves over two years. The “middle wave” was driven by a mutant involving its haemagglutinin & RNA polymerase (identified from naturally stored virus (1)).

How is this relevant to Covid-19?

H1N1 became the “driver” of influenza over the subsequent century. Within 3 years H1N1 had mutated into “seasonal” flu with a mortality less than 0.1%. The question is “Will this happen with SARS-CoV-2?”  We do not know but antigen drift and herd immunity (probably connected variables) ...

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