key: cord-0683322-i9kuhpvm
authors: nan
title: Underlying medical conditions associated with severe COVID‐19
date: 2021-09-03
journal: J Paediatr Child Health
DOI: 10.1111/jpc.15726
sha: 91634ea2de7a7591296c0c33b9d771bd14d180fc
doc_id: 683322
cord_uid: i9kuhpvm

nan

Long-term future of the COVID-19 pandemic

The long-term future of COVID-19 is a global concern. US researchers modeled the course of the pandemic based on immunological and epidemiological data on known endemic human coronaviruses. These include the four common childhood respiratory human coronaviruses and the two emerging coronaviruses with high mortality responsible for severe acute respiratory syndrome (SARS) and Middle-Eastern respiratory syndrome. 1 The data show that although naturally occurring infection-blocking immunity wanes fast, disease-reducing immunity is long-lasting. Their model incorporating immune characteristics was consistent with the benign clinical course of the childhood respiratory coronaviruses and the severe clinical course of SARS-CoV-2

infection. It suggested that as long as no variant emerges with greatly increased virulence in children, for which there is no evolutionary rationale, future primary exposure to SARS-CoV-2 will be a benign childhood disease likely to be no more virulent than the common cold viruses that are already established. This surprisingly optimistic prediction of future post-pandemic endemicity gives us hope of finally coming out of the pandemic and back to something like normality. What we need is to get over the initial 'hump' where older people's immune systems have not seen the virus before, something which vaccination provides. Figure 1 , and chronic and complex chronic disease (aRR 2.86, 95% CI 2.47-3.32). While considerably larger than other studies, there are limitations. In particular, the retrospective design precludes assigning causation. For example, children with type 1 diabetes or convulsions might be admitted to hospital or intensive care because of their underlying condition, and SARS-CoV-2 infection was almost incidental. Despite the limitations of this observational data, the results provide useful information on which to base targeted COVID-19 immunisation of children at greater risk of a bad outcome.

Reviewers: David Isaacs, david.isaacs@health.nsw.gov.au, Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney; Philip N Britton, philip.britton@health.nsw.gov.au, Department of Infectious Diseases and Microbiology, Children's Hospital at Westmead, Sydney Fig. 1 Association between medical comorbidities and severe illness when hospitalised in children with proven SARS-CoV-2 infection