Two pandemics of the 21st century: COVID-19 and «swine flu» of 2009

 This brief analytical review is devoted to spreading, etiology, pathogenesis, prophylaxis, and treatment of COVID-19 and “swine flu” causing pandemics in the 21st century. Both pandemics were caused by respiratory viruses belonging to different families, i.e., Coronaviridae (SARS-CoV-2) and Orthomyxoviridae (influenza A(H1N1)pdm09 virus), respectively. In most cases, pathogens enter human organisms via epithelial cells of the upper airways. Sometimes, these viruses infect intestinal epithelium. Given that symptoms of influenza and COVID-19 are similar, its diagnostics should always be based on laboratory results, especially, PCR evidence for specific RNA presence in clinical material. The paper describes similarities and differences in immune pathogenesis of the diseases. The main characteristics of two pandemic courses caused by SARS-CoV-2 and influenza A(H1N1)pdm09 are revealed. The presence of influenza vaccine and etiotropic chemotherapeutic agents, as well as preexisting immunity to influenza virus among elderly people in 2009 had a significant influence on morbidity and mortality during the influenza pandemic. The presence of antibodies to A(H1N1)pdm09 virus in sera of elderly people before the pandemic can be explained by the fact that some antigenic properties of A(H1N1) virus which circulated before 1957 were similar to that of A/California/07/09 (H1N1)pdm09. Consequently, morbidity and mortality among people older than 65 (main risk group) were low, while children and young adults suffered more often. The opposite pattern is observed for COVID-19, since mortality among the elderly population is high, while the children and young adults have an asymptomatic or mild form of a disease. A suggestion is made that population in the South-East Asia may have immunity against SARS-CoV-2, since coronaviruses with antigenic features similar to the pandemic one could circulate in that region and infect population without evident symptoms, while one or several recent virus variants caused severe disease and COVID-19 outbreak in Wuhan.

1. The Far East has limited contact with China because of the coronavirus [Electronic resource]. Access mode: https://iz.ru/967873/2020-01-24/dalnii-vostok-ogranichil-kontakty-s-kitaem-iz-za-koronavirusa.

2. Russian Government. COVID-19. Domestic and foreign policy [Electronic resource]. Access mode: http://government.ru/rugovclassifier/892/events/ (date of the application: 22.04.2020).

3. Rospotrebnadzor. On the registration of cases of diseases with a new coronavirus infection among Chinese citizens located in the territory of the Russian Federation [Electronic resource]. Access mode: https://www.rospotrebnadzor.ru/about/info/news/news_details.php?ELEMENT_ID=13601 (date of the application: 22.04.2020).

4. Rospotrebnadzor, 2009. Press releases. The situation of diseases caused by the highly pathogenic influenza virus A/California/04/2009 as of May 23, 2009.

5. Yatsyshina S.B., Minenko A.N., Kushakova T.F., Praded M.N., Kudryavtseva A.V., Shipulin G.A., Maleyev V.V., Pokrovsky V.I. Pandemic influenza A/H1N1 (SW2009) in Russia: epidemiology, diagnosis, clinical picture, and treatment. Terapevticheskiy arkhiv = Therapeutic Arhive, 2010, no. 11, pp. 10-14. (In Russ.)

6. Adlhoch C., Gomes Dias J., Bonmarin I., Hubert B., Larrauri A. et al. Determinants of Fatal Outcome in Patients Admitted to Intensive Care Units With Influenza, European Union 2009-2017. Open Forum Infect. Dis., 2019, Vol. 6, no. 11, ofz462. doi: 10.1093/ofid/ofz462.

7. Bhatraju P.K., Ghassemieh B.J., Nichols M., Kim R., Jerome K.R., Nalla A.K., Greninger A.L., Pipavath S., Wurfel M.M., Evans L., Kritek P.A., West T.E., Luks A., Gerbino A., Dale C.R., Goldman J.D., O’Mahony S., Mikacenic C. Covid-19 in Critically Ill Patients in the Seattle Region – Case Series. N. Engl. J. Med., 2020, NEJMoa2004500. doi: 10.1056/NEJMoa2004500.

8. Brydon E.W., Morris S.J., Sweet C. Role of apoptosis and cytokines in influenza virus morbidity. FEMS Microbiol. Rev., 2005, Vol. 29, no. 4, pp. 837-850.

9. Calvo C., López-Hortelano M.G., de Carlos Vicente J.C., Martínez J.L.V. Recommendations on the clinical management of infection with the «new coronavirus» SARS-CoV2. Working group of the Spanish Association of Pediatrics (AEP). An. Pediatr. (Barc.), 2020, Vol. 92, no. 4, pp. 241.e1-241.e11.

10. CDC, 2009. Outbreak of swine-origin influenza A (H1N1) virus infection – Mexico, March-April 2009. Morb. Mortal Wkly Rep., 2009, Vol. 58, no. 17, pp. 467-470.

11. CDC Bacterial coinfections in lung tissue specimens from fatal cases of 2009 pandemic influenza A (H1N1), United States, May-August, 2009. Morb. Mortal Wkly Rep., 2009, Vol. 58, pp. 1071-1074.

12. d’Amico F., Baumgart D.C., Danese S., Peyrin-Biroulet L. Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention and management. Clin. Gastroenterol. Hepatol., 2020. pii: S1542-3565(20)30481-X. doi: 10.1016/j.cgh.2020.04.001.

13. Gill J.R., Sheng Z.M., Ely S.F. Pulmonary pathologic findings of fatal 2009 pandemic influenza A/H1N1 viral infections. Arch. Pathol. Lab. Med., 2010, Vol. 134, no. 2, pp. 235-243.

14. Gorbalenya A.E., Baker S.C., Baric R.S., de Groot R.J., Drosten C., Gulyaeva A.A., Haagmans B.L., Lauber C., Leontovich A.M., Neuman B.W., Penzar D., Perlman S., Poon L.L.M., Samborskiy D.V., Sidorov I.A., Sola I., Ziebuhr J. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol., 202, Vol. 5, no. 4, pp. 536-544.

15. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., Liu L., Shan H., Lei C.L., Hui D.S.C., Du B., Li L.J., Zeng G., Yuen K.Y., Chen R.C., Tang C.L., Wang T., Chen P.Y., Xiang J., Li S.Y., Wang J.L., Liang Z.J., Peng Y.X., Wei L., Liu Y., Hu Y.H., Peng P., Wang J.M., Liu J.Y., Chen Z., Li G., Zheng Z.J., Qiu S.Q., Luo J., Ye C.J., Zhu S.Y., Zhong N.S. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med., 2020, Vol. 382, pp. 1708-1720.

16. Guo Y.R., Cao Q.D., Hong Z.S., Tan Y.Y., Chen S.D., Jin H.J., Tan K.S., Wang D.Y., Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak – an update on the status. Mil. Med. Res., 2020, Vol. 7, no. 1, 11. doi: 10.1186/s40779-020-00240-0.

17. Hancock K., Veguilla V., Lu X., Zhong W., Butler E.N., Sun H., Liu F., Dong L., DeVos J.R., Gargiullo P.M., Brammer T.L., Cox N.J., Tumpey T.M., Katz J.M. Cross-reactive antibody responses to the 2009 pandemic H1N1 influenza virus. N. Engl. J. Med., 2009, Vol. 361, no. 20, pp. 1945-1952.

18. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z., Yu T., Xia J., Wei Y., Wu W., Xie X., Yin W., Li H., Liu M., Xiao Y., Gao H., Guo L., Xie J., Wang G., Jiang R., Gao Z., Jin Q., Wang J., Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020, Vol. 395, no. 10223, pp. 497-506.

19. Ilyicheva T., Susloparov I., Durymanov A., Romanovskaya A., Sharshov K., Kurskaya O., Ignashkina M., Shestopalov A. Influenza A/H1N1pdm virus in Russian Asia in 2009-2010. Infect. Genet. Evol., 2011, Vol. 11, pp. 2107-2112.

20. International Committee on Taxonomy of Viruses (ICTV), 2017. Available at: https://talk.ictvonline.org.

21. Konrad R., Eberle U., Dangel A., Treis B., Berger A., Bengs K., Fingerle V., Liebl B., Ackermann N., Sing A. Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020. Euro Surveill., 2020, Vol. 25, no. 9, 2000173. doi: 10.2807/1560-7917.ES.2020.25.9.2000173.

22. Lane R. Sarah Gilbert: carving a path towards a COVID-19 vaccine. Lancet, 2020, Vol. 395, no. 10232, 1247. doi: 10.1016/S0140-6736(20)30796-0.

23. Lao W.P., Imam S.A., Nguyen S.A. Anosmia, hyposmia, and dysgeusia as indicators for positive SARSCoV-2 infection. World J. Otorhinolaryngol. Head Neck Surg., 2020. doi: 10.1016/j.wjorl.2020.04.001.

24. Leung G.M., Chung P.H., Tsang T., Lim W., Chan S.K., Chau P., Donnelly C.A., Ghani A.C., Fraser C., Riley S., Ferguson N.M., Anderson R.M., Law Y.L., Mok T., Ng T., Fu A., Leung P.Y., Peiris J.S., Lam T.H., Hedley A.J. SARS-CoV antibody prevalence in all Hong Kong patient contacts. Emerg. Infect. Dis., 2004, Vol. 10, no. 9, pp. 1653-1656.

25. Li Q., Guan X., Wu P. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med., 2020. doi: 10.1056/NEJMoa2001316.

26. Li G., He X., Zhang L., Ran Q., Wang J., Xiong A., Wu D., Chen F., Sun J., Chang C. Assessing ACE2 expression patterns in lung tissues in the pathogenesis of COVID-19. J. Autoimmun., 2020, 102463. doi: 10.1016/j.jaut.2020.102463.

27. Lorusso A., Calistri P., Mercante M.T., Monaco F., Portanti O., Marcacci M., Cammà C., Rinaldi A., Mangone I., di Pasquale A., Iommarini M., Mattucci M., Fazii P., Tarquini P., Mariani R., Grimaldi A., Morelli D., Migliorati G., Savini G., Borrello S., d’Alterio N. A “One-Health” approach for diagnosis and molecular characterization of SARSCoV-2 in Italy. One Health, 2020, 100135. doi: 10.1016/j.onehlt.2020.100135.

28. Payne S. Viruses. Academic Press, 2017, pp. 197-208.

29. Peiris J.S.M., Guan Y., Yuen K.Y. Severe acute respiratory syndrome. Nat. Med., 2004, Vol. 10, Suppl. 12, pp. S88-S97.

30. Perrier A., Bonnin A., Desmarets L., Danneels A., Goffard A., Rouille Y., Dubuisson J., Belouzard S. The C-terminal domain of the MERS coronavirus M protein contains a trans-Golgi network localization signal. J. Biol. Chem., 2019, Vol. 294, no. 39, pp. 14406-14421.

31. Rokni M., Ghasemi V., Tavakoli Z. Immune responses and pathogenesis of SARS-CoV-2 during an outbreak in Iran: Comparison with SARS and MERS. Rev. Med. Virol., 2020, Vol. 30, no. 3, e2107. doi: 10.1002/rmv.2107.

32. Shrestha S.S., Swerdlow D.L., Borse R.H., Prabhu V.S., Finelli L., Atkins C.Y., Owusu-Edusei K., Bell B., Mead P.S., Biggerstaff M., Brammer L., Davidson H., Jernigan D., Jhung M.A., Kamimoto L.A., Merlin T.L., Nowell M., Redd S.C., Reed C., Schuchat A., Meltzer M.I. Estimating the burden of 2009 pandemic influenza A (H1N1) in the United States (April 2009 – April 2010). Clin. Infect. Dis., 2011, Vol. 52, Suppl. 1. pp. S75-S82.

33. Simonsen L., Spreeuwenberg P., Lustig R., Taylor R.J., Fleming D.M., Kroneman M., van Kerkhove M.D., Mounts A.W., Paget W.J.; GLaMOR Collaborating Teams. Global mortality estimates for the 2009 Influenza Pandemic from the GLaMOR project: a modeling study. PLoS Med., 2013, Vol. 10, no. 11, e1001558. doi: 10.1371/journal.pmed.1001558.

34. Singhal T. A review of coronavirus disease – 2019 (COVID-19). Indian J. Pediatr., 2020, Vol. 87, no. 4, pp. 281-286.

35. Tong S., Li Y., Rivailler P., Conrardy C., Castillo D.A., Chen L.M., Recuenco S., Ellison J.A., Davis C.T., York I.A., Turmelle A.S., Moran D., Rogers S., Shi M., Tao Y., Weil M.R., Tang K., Rowe L.A., Sammons S., Xu X., Frace M., Lindblade K.A., Cox N.J., Anderson L.J., Rupprecht C.E., Donis R.O. A distinct lineage of influenza A virus from bats. Proc. Natl. Acad. Sci USA, 2012, Vol. 109, no. 11, pp. 4269-4274.

36. WHO Novel coronavirus (2019-nCoV) situation report – 3, 2020. Access mode: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200123-sitrep-3-2019-ncov.pdf (Accessed 26 April 2020).

37. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March. Access mode: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-oncovid-19---11-march-2020 (Accessed 26 April 2020).

38. WHO, 2010. What is a pandemic? 24 February 2010. Access mode: http://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/index.html (Accessed 22 April 2020).

39. WHO, 2009. World now at the start of 2009 influenza pandemic. Access mode: http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html (Accessed 26 April 2020).

40. WHO, 2010. H1N1 in post-pandemic period. Access mode: http://www.who.int/mediacentre/news/statements/2010/h1n1_vpc_20100810/en/index.html (Accessed 26 April 2020).

41. WHO. Clinical management of swine flu. 2010. Access mode: http://www.who.int/csr/resources/publications/swineflu/clinical_management/en/index.html (Accessed 22 April 2020).

42. WHO (2010) Pandemic (H1N1) 2009 – update 112. Access mode: http://www.who.int/csr/don/2010_08_06/en/index.html (Accessed 26 April 2020).

43. Xu R., McBride R., Nycholat C.M., Paulson J.C., Wilson I.A. Structural characterization of the hemagglutinin receptor specificity from the 2009 H1N1 influenza pandemic. J. Virol., 2012, Vol. 86, no. 2, pp. 982-990.

44. Yin Y., Wunderink R.G. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology, 2018, Vol. 23, no. 2, pp. 130-137.

45. Zhang H., Li H.B., Lyu J.R., Lei X.M., Li W., Wu G., Lyu J., Dai Z.M. Specific ACE2 expression in small intestinal enterocytes may cause gastrointestinal symptoms and injury after 2019-nCoV infection. Int. J. Infect. Dis., 2020, Vol. 96, pp. 19-24.

46. Zhang W., Du R.H., Li B., Zheng X.S., Yang X.L., Hu B., Wang Y.Y., Xiao G.F., Yan B., Shi Z.L., Zhou P. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg. Microbes Infect., 2020, Vol. 9, no. 1, pp. 386-389.