Mini Episode 1: Immunity Debt, COVID-19, and White Lung Syndrome

In this episode Dr. Matheu challenges the hypothesis of “Immunity Debt” with real-world data and well established Immunology providing a counter hypothesis to the question of “why are we all getting so sick?” by explaining how Sars-CoV-2 causes immune system dysfunction and dysregulation. The episode finishes with questions about “White Lung Syndrome” the popularized term for the uptick in severe childhood pneumonia across the northern hemisphere this winter cold and flu season (2023-24). Companion reading can be found here: LIL’ Science Substack. References: Immune debt: Recrudescence of disease and confirmation of a contested concept. Cohen, R. et al. Infect Dis Now. March 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9756601/#Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Cohen, R. et al. Infect Dis Now. August 2021https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114587/Respiratory Syncytial Virus Infection: Immune Response, Immunopathogenesis, and Treatment. Domachowske, J.B. and Rosenberg, H.F Clin Microbiol Rev. April, 1999 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88919/Immunity to RSV in Early-Life Lambert, L. et al. Frontiers in Immunology. September 2014 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179512/Humoral and cellular immunity to RSV in infants, children and adults Green, C.A. et al. Vaccine October, 2018 https://pubmed.ncbi.nlm.nih.gov/30177258/Respiratory Syncytial Virus Infection (RSV) CDC https://www.cdc.gov/rsv/about/symptoms.html“Sweden's king says 'we have failed' over COVID-19, as deaths mount” ReutersDecember, 2020 https://www.reuters.com/article/health-coronavirus-sweden-king-idUSKBN28R1IG/Sweden’s Gamble: The country’s pandemic policies came at a high price - and created painful rifts in its scientific community. Science Vogel, G. October 2020 https://www.science.org/content/article/it-s-been-so-so-surreal-critics-sweden-s-lax-pandemic-policies-face-fierce-backlashInfluenza in Sweden – Season 2022–2023 The Public Health Agency of SwedenSeptember 2023 https://www.folkhalsomyndigheten.se/publikationer-och-material/publikationsarkiv/i/influenza-in-sweden-season-2022-2023/?pub=126761RSV in Sweden – Season 2022–2023, The Public Health Agency of Sweden https://www.folkhalsomyndigheten.se/globalassets/statistik-uppfoljning/smittsamma-sjukdomar/veckorapporter-rsv/rsv-sasongen-2022-2023.pdfIntensified circulation of respiratory syncytial virus (RSV) and associated hospital burden in the EU/EEA European Centre For Disease Prevention And Control, December 2022 https://www.ecdc.europa.eu/sites/default/files/documents/RRA-20221128-473.pdfNotes from the Field: COVID-19–Associated Mucormycosis — Arkansas, July–September 2021,  Dulski, T.M. CDC MMWR December, 2021 https://www.cdc.gov/mmwr/volumes/70/wr/mm7050a3.htmT cell response to SARS-CoV-2 infection in humans: A systematic review, Madhumita, S. et al. PLoS One, January 2021 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833159/A comprehensive review about immune responses and exhaustion during coronavirus disease (COVID-19), Mohammed, R.N. et al. Cell Commun Signal, June 2022 https://pubmed.ncbi.nlm.nih.gov/35655192/Severe COVID-19 patients have impaired plasmacytoid dendritic cell-mediated control of SARS-CoV-2, Venet, M. et al. Nat Commun February, 2023 https://www.nature.com/articles/s41467-023-36140-9The detectable anti-interferon-γ autoantibodies in COVID-19 patients may be associated with disease severity Chen, P.K. et al. Virol J February, 2023 https://virologyj.biomedcentral.com/articles/10.1186/s12985-023-01989-1B lymphocytes in COVID-19: a tale of harmony and discordance Mansourabadi, A.H. Arch Virol, April 2023 https://pubmed.ncbi.nlm.nih.gov/37119286/Severe COVID-19 may lead to long-term innate immune system changes, National Institutes of Health August, 2023 https://covid19.nih.gov/news-and-stories/severe-covid-19-may-cause-long-term-immune-system-changesIncreased Risk of Herpes Zoster in Adults ≥50 Years Old Diagnosed With COVID-19 in the United States, Bhavsar, A, Open Forum Infect Dis, March 2022 https://pubmed.ncbi.nlm.nih.gov/35392454/Incidence of Epstein-Barr virus reactivation is elevated in COVID-19 patients, Bernal, K.D.E. and Whitehurst, C.B. Virus Res. September, 2023 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10292739/Risk of autoimmune diseases in patients with COVID-19: A retrospective cohort study, Chang, R. et al. eClinicalMedicine February 2023 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830133/Remodeling of T Cell Dynamics During Long COVID Is Dependent on Severity of SARS-CoV-2 Infection, Wiech, M. et al. Front Immunol. June 2022 https://pubmed.ncbi.nlm.nih.gov/35757700/