A mathematical model for the within-host (re)infection dynamics of SARS-CoV-2

Abstract: Interactions between SARS-CoV-2 and the immune system during infection are complex. However, understanding the within-host SARS-CoV-2 dynamics is of enormous importance, especially when it comes to assessing treatment options. Mathematical models have been developed to describe the within-host SARS-CoV-2 dynamics and to dissect the mechanisms underlying COVID-19 pathogenesis. Current mathematical models focus on the acute infection phase, thereby ignoring important post-acute infection effects. We present a mathematical model, which not only describes the SARS-CoV-2 infection dynamics during the acute infection phase, but also reflects the recovery of the number of susceptible epithelial cells to an initial pre-infection homeostatic level, shows clearance of the infection within the individual, immune waning, and the formation of long-term immune response levels after infection. Moreover, the model accommodates reinfection events assuming a new virus variant with either increased infectivity or immune escape. Together, the model provides an improved reflection of the SARS-CoV-2 infection dynamics within humans, particularly important when using mathematical models to develop or optimize treatment options.