Emergence and competition of virus variants in respiratory viral infections.

The emergence of new variants of concern (VOCs) of the SARS-CoV-2 infection is one of the main factors of epidemic progression. Their development can be characterized by three critical stages: virus mutation leading to the appearance of new viable variants; the competition of different variants leading to the production of a sufficiently large number of copies; and infection transmission between individuals and its spreading in the population. The first two stages take place at the individual level (infected individual), while the third one takes place at the population level with possible competition between different variants. This work is devoted to the mathematical modeling of the first two stages of this process: the emergence of new variants and their progression in the epithelial tissue with a possible competition between them. The emergence of new virus variants is modeled with non-local reaction-diffusion equations describing virus evolution and immune escape in the space of genotypes. The conditions of the emergence of new virus variants are determined by the mutation rate, the cross-reactivity of the immune response, and the rates of virus replication and death. Once different variants emerge, they spread in the infected tissue with a certain speed and viral load that can be determined through the parameters of the model. The competition of different variants for uninfected cells leads to the emergence of a single dominant variant and the elimination of the others due to competitive exclusion. The dominant variant is the one with the maximal individual spreading speed. Thus, the emergence of new variants at the individual level is determined by the immune escape and by the virus spreading speed in the infected tissue.

Mathematical modeling of respiratory viral infection and applications to SARS-CoV-2 progression.

Viral infection in cell culture and tissue is modeled with delay reaction-diffusion equations. It is shown that progression of viral infection can be characterized by the viral replication number, time-dependent viral load, and the speed of infection spreading. These three characteristics are determined through the original model parameters including the rates of cell infection and of virus production in the infected cells. The clinical manifestations of viral infection, depending on tissue damage, correlate with the speed of infection spreading, while the infectivity of a respiratory infection depends on the viral load in the upper respiratory tract. Parameter determination from the experiments on Delta and Omicron variants allows the estimation of the infection spreading speed and viral load. Different variants of the SARS-CoV-2 infection are compared confirming that Omicron is more infectious and has less severe symptoms than Delta variant. Within the same variant, spreading speed (symptoms) correlates with viral load allowing prognosis of disease progression.

An age-dependent immuno-epidemiological model with distributed recovery and death rates.

The work is devoted to a new immuno-epidemiological model with distributed recovery and death rates considered as functions of time after the infection onset. Disease transmission rate depends on the intra-subject viral load determined from the immunological submodel. The age-dependent model includes the viral load, recovery and death rates as functions of age considered as a continuous variable. Equations for susceptible, infected, recovered and dead compartments are expressed in terms of the number of newly infected cases. The analysis of the model includes the proof of the existence and uniqueness of solution. Furthermore, it is shown how the model can be reduced to age-dependent SIR or delay model under certain assumptions on recovery and death distributions. Basic reproduction number and final size of epidemic are determined for the reduced models. The model is validated with a COVID-19 case data. Modelling results show that proportion of young age groups can influence the epidemic progression since disease transmission rate for them is higher than for other age groups.

Modelling of the Innate and Adaptive Immune Response to SARS Viral Infection, Cytokine Storm and Vaccination.

In this work, we develop mathematical models of the immune response to respiratory viral infection, taking into account some particular properties of the SARS-CoV infections, cytokine storm and vaccination. Each model consists of a system of ordinary differential equations that describe the interactions of the virus, epithelial cells, immune cells, cytokines, and antibodies. Conventional analysis of the existence and stability of stationary points is completed by numerical simulations in order to study the dynamics of solutions. The behavior of the solutions is characterized by large peaks of virus concentration specific to acute respiratory viral infections. At the first stage, we study the innate immune response based on the protective properties of interferon secreted by virus-infected cells. Viral infection down-regulates interferon production. This competition can lead to the bistability of the system with different regimes of infection progression with high or low intensity. After that, we introduce the adaptive immune response with antigen-specific T- and B-lymphocytes. The resulting model shows how the incubation period and the maximal viral load depend on the initial viral load and the parameters of the immune response. In particular, an increase in the initial viral load leads to a shorter incubation period and higher maximal viral load. The model shows that a deficient production of antibodies leads to an increase in the incubation period and even higher maximum viral loads. In order to study the emergence and dynamics of cytokine storm, we consider proinflammatory cytokines produced by cells of the innate immune response. Depending on the parameters of the model, the system can remain in the normal inflammatory state specific for viral infections or, due to positive feedback between inflammation and immune cells, pass to cytokine storm characterized by the excessive production of proinflammatory cytokines. Finally, we study the production of antibodies due to vaccination. We determine the dose-response dependence and the optimal interval of vaccine dose. Assumptions of the model and obtained results correspond to the experimental and clinical data.

Combining Computational Modelling and Machine Learning to Identify COVID-19 Patients with a High Thromboembolism Risk

Severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) is a respiratory virus that disrupts the functioning of several organ systems. The cardiovascular system represents one of the systems targeted by the novel coronavirus disease (COVID-19). Indeed, a hypercoagulable state was observed in some critically ill COVID-19 patients. The timely prediction of thrombosis risk in COVID-19 patients would help prevent the incidence of thromboembolic events and reduce the disease burden. This work proposes a methodology that identifies COVID-19 patients with a high thromboembolism risk using computational modelling and machine learning. We begin by studying the dynamics of thrombus formation in COVID-19 patients by using a mathematical model fitted to the experimental findings of in vivo clot growth. We use numerical simulations to quantify the upregulation in the size of the formed thrombi in COVID-19 patients. Next, we show that COVID-19 upregulates the peak concentration of thrombin generation (TG) and its endogenous thrombin potential. Finally, we use a simplified 1D version of the clot growth model to generate a dataset containing the hemostatic responses of virtual COVID-19 patients and healthy subjects. We use this dataset to train machine learning algorithms that can be readily deployed to predict the risk of thrombosis in COVID-19 patients.

An Epidemic Model with Time Delay Determined by the Disease Duration

Immuno-epidemiological models with distributed recovery and death rates can describe the epidemic progression more precisely than conventional compartmental models. However, the required immunological data to estimate the distributed recovery and death rates are not easily available. An epidemic model with time delay is derived from the previously developed model with distributed recovery and death rates, which does not require precise immunological data. The resulting generic model describes epidemic progression using two parameters, disease transmission rate and disease duration. The disease duration is incorporated as a delay parameter. Various epidemic characteristics of the delay model, namely the basic reproduction number, the maximal number of infected, and the final size of the epidemic are derived. The estimation of disease duration is studied with the help of real data for COVID-19. The delay model gives a good approximation of the COVID-19 data and of the more detailed model with distributed parameters.

Competition of SARS-CoV-2 Variants in Cell Culture and Tissue: Wins the Fastest Viral Autowave.

Replication of viruses in living tissues and cell cultures is a "number game" involving complex biological processes (cell infection, virus replication inside infected cell, cell death, viral degradation) as well as transport processes limiting virus spatial propagation. In epithelial tissues and immovable cell cultures, viral particles are basically transported via Brownian diffusion. Highly non-linear kinetics of viral replication combined with diffusion limitation lead to spatial propagation of infection as a moving front switching from zero to high local viral concentration, the behavior typical of spatially distributed excitable media. We propose a mathematical model of viral infection propagation in cell cultures and tissues under the diffusion limitation. The model is based on the reaction-diffusion equations describing the concentration of uninfected cells, exposed cells (infected but still not shedding the virus), virus-shedding cells, and free virus. We obtain the expressions for the viral replication number, which determines the condition for spatial infection progression, and for the final concentration of uninfected cells. We determine analytically the speed of spatial infection propagation and validate it numerically. We calibrate the model to recent experimental data on SARS-CoV-2 Delta and Omicron variant replication in human nasal epithelial cells. In the case of competition of two virus variants in the same cell culture, the variant with larger individual spreading speed wins the competition and eliminates another one. These results give new insights concerning the emergence of new variants and their spread in the population.

An Epidemic Model with Time-Distributed Recovery and Death Rates.

A compartmental epidemiological model with distributed recovery and death rates is proposed. In some particular cases, the model can be reduced to the conventional SIR model. However, in general, the dynamics of epidemic progression in this model is different. Distributed recovery and death rates are evaluated from COVID-19 data. The model is validated by the epidemiological data for different countries, and it shows better agreement with the data than the SIR model. The time-dependent disease transmission rate is estimated.

Infection spreading in cell culture as a reaction-diffusion wave: RAIRO: Numerical Analysis

Infection spreading in cell culture occurs due to virus replication in infected cells and its random motion in the extracellular space. Multiplicity of infection experiments in cell cultures are conventionally used for the characterization of viral infection by the number of viral plaques and the rate of their growth. We describe this process with a delay reaction-diffusion system of equations for the concentrations of uninfected cells, infected cells, virus, and interferon. Time delay corresponds to the duration of viral replication inside infected cells. We show that infection propagates in cell culture as a reaction-diffusion wave, we determine the wave speed and prove its existence. Next, we carry out numerical simulations and identify three stages of infection progression: infection decay during time delay due to virus replication, explosive growth of viral load when infected cells begin to reproduce it, and finally, wave-like infection progression in cell culture characterized by a constant or slowly growing total viral load. The modelling results are in agreement with the experimental data for the coronavirus infection in a culture of epithelial cells and for some other experiments. The presence of interferon produced by infected cells decreases the viral load but does not change the speed of infection progression in cell culture. In the 2D modelling, the total viral load grows faster than in the 1D case due to the increase of plaque perimeter.

Blood Clotting Decreases Pulmonary Circulation during the Coronavirus Disease

Spontaneous blood clotting in pulmonary circulation caused by thrombo-inflammation is one of the main mortality causes during the COVID-19 disease. Blood clotting leads to reduced pulmonary circulation and blood oxygenation. Lung inflammation can be evaluated with noninvasive diagnostic techniques. However, the correlation of the severity of the inflammation with the pulmonary blood flow has not been established. To address this question, in this work, we develop a multiscale model taking into account the interaction of a local model of thrombus growth with 1D hemodynamics in a vessel network. Flux reduction depending on the level of lung obstruction is evaluated. In particular, the model obtains that an obstruction level of 5% leads to a 12% reduction of blood flux. The suggested approach can be used to investigate the interaction of blood clotting and flow not only in the pulmonary network but also in other complex vessel networks.

Epidemic Progression and Vaccination in a Heterogeneous Population. Application to the Covid-19 epidemic

The paper is devoted to a compartmental epidemiological model of infection progression in a heterogeneous population which consists of two groups with high disease transmission (HT) and low disease transmission (LT) potentials. Final size and duration of epidemic, the total and current maximal number of infected individuals are estimated depending on the structure of the population. It is shown that with the same basic reproduction number R0 in the beginning of epidemic, its further progression depends on the ratio between the two groups. Therefore, fitting the data in the beginning of epidemic and the determination of R0 are not sufficient to predict its long time behaviour. Available data on the Covid-19 epidemic allows the estimation of the proportion of the HT and LT groups. Estimated structure of the population is used for the investigation of the influence of vaccination on further epidemic development. The result of vaccination strongly depends on the proportion of vaccinated individuals between the two groups. Vaccination of the HT group acts to stop the epidemic and essentially decreases the total number of infected individuals at the end of epidemic and the current maximal number of infected individuals while vaccination of the LT group only acts to protect vaccinated individuals from further infection.

On a quarantine model of coronavirus infection and data analysis

Attempts to curb the spread of coronavirus by introducing strict quarantine measures apparently have different effect in different countries: while the number of new cases has reportedly decreased in China and South Korea, it still exhibit significant growth in Italy and other countries across Europe. In this brief note, we endeavour to assess the efficiency of quarantine measures by means of mathematical modelling. Instead of the classical SIR model, we introduce a new model of infection progression under the assumption that all infected individual are isolated after the incubation period in such a way that they cannot infect other people. Disease progression in this model is determined by the basic reproduction number R0 (the number of newly infected individuals during the incubation period), which is different compared to that for the standard SIR model. If R0 > 1, then the number of latently infected individuals exponentially grows. However, if R0 < 1 (e.g. due to quarantine measures and contact restrictions imposed by public authorities), then the number of infected decays exponentially. We then consider the available data on the disease development in different countries to show that there are three possible patterns: growth dynamics, growth-decays dynamics, and patchy dynamics (growth-decay-growth). Analysis of the data in China and Korea shows that the peak of infection (maximum of daily cases) is reached about 10 days after the restricting measures are introduced. During this period of time, the growth rate of the total number of infected was gradually decreasing. However, the growth rate remains exponential in Italy. Arguably, it suggests that the introduced quarantine is not sufficient and stricter measures are needed.

Extended SEIQR type model for COVID-19 epidemic and data analysis.

An extended SEIQR type model is considered in order to model the COVID-19 epidemic. It contains the classes of susceptible individuals, exposed, infected symptomatic and asymptomatic, quarantined, hospitalized and recovered. The basic reproduction number and the final size of epidemic are determined. The model is used to fit available data for some European countries. A more detailed model with two different subclasses of susceptible individuals is introduced in order to study the influence of social interaction on the disease progression. The coefficient of social interaction K characterizes the level of social contacts in comparison with complete lockdown (K=0) and the absence of lockdown (K=1). The fitting of data shows that the actual level of this coefficient in some European countries is about 0.1, characterizing a slow disease progression. A slight increase of this value in the autumn can lead to a strong epidemic burst.