Yet there may be a biological mechanism behind this epidemiological anomaly. Individuals suffering the most may have been primed by one or more prior coronavirus exposures, and due to antigenic epitope heterogeneity, are experiencing the effects of antibody dependent enhancement (ADE).
This postulate isn’t novel as it has been found and characterized in the SARS coronavirus, SARS-CoV. Enhancement was identified by Yang et al. [
6] in 2005 and was hypothesized as being the reason for such a high mortality rate in China [
7].