Title The past, current and future epidemiological dynamic of SARS-CoV-2.
Author Balloux, Francois; Tan, Cedric; Swadling, Leo; Richard, Damien; Jenner, Charlotte; Maini, Mala; van Dorp, Lucy
Journal Oxf Open Immunol Publication Year/Month 2022
PMID 35872966 PMCID PMC9278178
Affiliation + expend 1.UCL Genetics Institute, University College London, London WC1E 6BT, UK.

SARS-CoV-2, the agent of the COVID-19 pandemic, emerged in late 2019 in China, and rapidly spread throughout the world to reach all continents. As the virus expanded in its novel human host, viral lineages diversified through the accumulation of around two mutations a month on average. Different viral lineages have replaced each other since the start of the pandemic, with the most successful Alpha, Delta and Omicron variants of concern (VoCs) sequentially sweeping through the world to reach high global prevalence. Neither Alpha nor Delta was characterized by strong immune escape, with their success coming mainly from their higher transmissibility. Omicron is far more prone to immune evasion and spread primarily due to its increased ability to (re-)infect hosts with prior immunity. As host immunity reaches high levels globally through vaccination and prior infection, the epidemic is expected to transition from a pandemic regime to an endemic one where seasonality and waning host immunization are anticipated to become the primary forces shaping future SARS-CoV-2 lineage dynamics. In this review, we consider a body of evidence on the origins, host tropism, epidemiology, genomic and immunogenetic evolution of SARS-CoV-2 including an assessment of other coronaviruses infecting humans. Considering what is known so far, we conclude by delineating scenarios for the future dynamic of SARS-CoV-2, ranging from the good-circulation of a fifth endemic \'common cold\' coronavirus of potentially low virulence, the bad-a situation roughly comparable with seasonal flu, and the ugly-extensive diversification into serotypes with long-term high-level endemicity.

  • Copyright © 2023
    National Institute of Pathogen Biology, CAMS & PUMC, Bejing, China
    All rights reserved.