ABSTRACT
Survivors of SARS-CoV-2 (Covid-19) infections have a unique immune
response that allows them to either delay reinfection or outsmarts the
virus’s whims. The emergence of new SARS-CoV-2 variants and immunization
have furthered this immune response by producing high-affinity
anti-SARS-CoV-2 antibodies. There is limited data on the extent to which
this immune response confers protective immunity against recurrent
infections, as well as the duration of this protection. Here we present
the first-ever quantum mechanical model to provide an answer to this
question. The model is well applicable because of the 20 nm -500 nm size
range of coronavirus. We call this model the ‘Quantum Perturbation
Model’. The model relates the strength of the COVID-19 attack to a wave
function containing information about the system (person infected by the
SARS-CoV-2) and quantized energy states, which shows the chances of
reoccurrence of the disease. By applying the energy corrections provided
by the Quantum Perturbation Theory to the SARS-CoV-2 attack under
reinfections and various pre-existing conditions we have provided
possible interpretations. When pre-existing problems exist at the time
of SARS-COV-2 infection, the model illustrates how the influence of
COVID-19 accumulates up. The model also formulates the deficit in the
intensity of the COVID-19 effect in recurrence or in the presence of
other variables strengthening the body’s antibody affinity and immunity
to resist the virus variants.
KEYWORDS: SARS-COV-2, immunity system response, quantum
mechanical modeling, quantum perturbation theory,
INTRODUCTION
The outbreak of severe acute respiratory syndrome (SARS)-like
coronavirus, SARS-CoV-2, around the globe has caused ripples and spurred
researchers to take alternative strategies to deal with the new
SARS-CoV-2 infection (Baric et al., 2020). With 169 million cases and
3.51 million deaths worldwide, the World Health Organization (WHO), the
United States Centers for Disease Control and Prevention (CDC), and the
European Center for Disease Prevention and Control (ECDC) have declared
COVID-19 one of the deadliest pandemics in the modern human history
(Baric 2020; Lv et al., 2020). SARS-CoV-2 causes COVID-19 when it enters
the body through the nose, mouth, or eyes and finds its way to our cells
through its surface spike protein (Pillalamarri et al. 2021). Its entry
into host cells is a key factor in viral pathogenicity, infectivity, and
immunity (Li et al., 2016). Once inside the cells, SARS-CoV-2 replicates
itself utilizing host cellular machinery, producing virally encoded
proteins that copy its viral genetic material and induce infection (Khan
et al., 2020). When a cell is infected with viruses, it ruptures
(Chatterjee et al., 2021). This causes the cell to die, and the virus
particles can go on to infect more cells (Lv et al., 2020; Singhal et
al., 2020; Shereen et al. 2020). The virus evades our immune system by
changing over time, resulting in genetic mutations in the population of
circulating viral strains that dampen our immune response ( Li et al.,
2021). Coughing or sneezing of a COVID-19 affected person is a leading
cause of the spread of this virus and the disease. The infected person
can spray droplets as far as 6 feet away during a cough or sneeze (Lv et
al., 2020; Shereen et al. 2020). . The latest data on the COVID-19
indicates that only 17% of people infected with SARS-CoV-2 show no
symptoms and these individuals are 42% less likely to transmit the
virus (Byambasuren et al., 2020).
Despite the fact that SARS-CoV-2 has the ability to hijack our immune
system, we must remember that our body’s natural defenses are intended
to develop efficient antibodies against a specific invader (Ullah et
al., 2021; Vardhana et al., 2020; Yazdanpanah et al., 2020). Our immune
system remembers how it dealt with pathogens previously (Yazdanpanah et
al., 2020). When an individual is re-infected with the same pathogen,
our immune system recognizes it and protects us (Gasteiger et al.,
2017). In the case of SARS-CoV-2 infection, recovery does provide a
degree of immunity, but there have been cases where the second infection
was fatal (Bi et al., 2020; Parry et al., 2020). To date, there is no
information available that anyone has been infected a third time, though
the possibility may exist as circulation of variants such as B.1.1.7 or
B.1.1.28 has been reported in several countries (Voloch et al., 2021;
Sabino et al., 2021). In the event, if a third re-infection occurs and
the patient recovers, it will aid in the building of long-term immunity,
eventually leading to eternal immunity, based on our existing immunology
understanding.
In multiple case study reports, researchers have discovered that
pre-existing chronic conditions such as heart disease, cancer, or
digestive diseases are reinforcing factors for SARS-CoV-2 and that a
more severe viral attack is expected in such patients. In simple words,
a person with a pre-existing condition like heart disease can be
affected more by the COVID-19 (Sanyaolu et al., 2020; Zheng et al.,
2020; Mao et al., 2020). Based on the reported data of 76993 patients,
Emami et al. reported that cardiovascular diseases, hypertension,
smoking, diabetes mellitus, chronic obstructive pulmonary disease
(COPD), malignancy, and chronic kidney disease were among the most
prevalent underlying diseases among hospitalized COVID-19 patients,
respectively (Emami et al., 2020).
The SARS-CoV-2 infection can damage the heart in many ways. For example,
the virus may directly attack and inflame the heart muscle, affecting
blood flow and the supply of oxygen to the body part. COVID-19 seems to
promote the development of cardiovascular disorders, such as myocardial
injury, arrhythmias, acute coronary syndrome (ACS), and venous
thromboembolism (Shi et al., 2020; Dai et al., 2020; Shi et al., 2020).
Children with COVID-19 have also been reported to develop
hyperinflammatory shock with features akin
to Kawasaki
disease, including cardiac dysfunction and coronary vessel
abnormalities (Dai et al., 2020). Similarly, cancer patients are also at
the forefront of risk from COVID-19 and have a disproportionately high
death rate (Williamson et al., 2020; Sud et al., 2020; Tillett et al.,
2021; Azam et al., 2020). Clearly, some of these factors relate to
immune suppression and chemotherapy and hence we can say that COVID-19
could have a more severe effect on those who have pre-existing serious
disorders.
Through case studies of several COVID-19 patients, researchers
discovered that re-infection and recurrence of COVID-19 is possible in
patients who survived the first COVID-19 attack. According to a recent
study, those who had COVID 19 had an 84 % lower chance of reinfection
and a 93 % reduced risk of symptomatic SARS-CoV-2 infection (Hall et
al., 2021). Clinicians and researchers presented a case study on a range
of patients and investigated SARS-COV-2 infection as well as the impact
of COVID-19 on patients with various conditions. They reported eleven
COVID-19 patients having experienced a second clinically- and
virologically confirmed acute COVID-19 episode (Bonifacio et al., 2020;
Gousseff et al., 2020). Several cases of recurrence have also been
reported in other parts of the world (Jiang et al., 2020).
The purpose of this study is to develop a proper model based on the
Quantum Perturbation Theory that provides information and a pathway to
recurrence of COVID-19 under various conditions affecting the immunity
and affinity of the body.
BACKGROUND AND SIGNIFICANCE
Keeping the severity of the COVID-19 attack in the presence of a
pre-existing major disease and recurrence of the attack, it is important
to model the effect of SARS-CoV-2 infection and its progress.
Researchers have reported various aspects of COVID-19 attack, the
severity of the developed infection, and the outcomes. However, a search
is still going on to find a proper model explaining how the strength of
COVID-19 infection is affected by pre-existing diseases and how the
strength and chances of recurrence vary under various conditions and
factors.
In this paper, we developed the first Quantum Mechanical Model based on
Quantum Perturbation Theory. We call it the “Quantum Perturbation
Model” to model COVID-19 infections and the immune response of the
affected body. The model describes how the effect of COVID-19 adds up
when pre-existing major diseases exist at the time of coronavirus
attack. The model also formulizes the weakness in the strength of the
COVID-19 effect in recurrence or in the presence of other factors
boosting the affinity and immunity of the body to resist. This quantum
perturbation model is uniquely significant because the model is well
suited to formulize COVID-19 because of the 20 nm -500 nm size range of
coronavirus, which is exactly matching with the quantum mechanical
limits of explaining the phenomenon and outcomes that cannot be
explained and solved by the traditional approaches. Many phenomena and
effects like single-electron tunneling in a biological system, alpha
decay, electrons tunneling in physical and biological systems, and
behavior of neurons have been successfully modeled and explained when
all other approaches have failed. We hypothesize that a microscopic
cellular event must be viewed as a quantum entity (system) in the
context that it is complex and confined in space and time. These
cellular events rely on a limited (unlimited) number of molecules that
are densely packed and can occur within a relatively short period,
leaving them accessible to the possibility that quantum mechanical
processes can play an important role in biological systems.
Another unique and significant outcome of this model is that any
COVID-19 patient who shows a different path of variation in the Covid-19
effect (other than predicted and prescribed by this model) has either
been suffering from another underlying disease which is not been
diagnosed yet or has another affinity factor which is yet to be
detected.
FUNDAMENTAL MECHANISM OF PERPETUAL IMMUNITY TO SARS-COV-2
INFECTION
Our immune system is very versatile, capable of fighting a wide range of
infections and possessing a memory that allows for a robust response to
previously encountered pathogens. When an antigen attacks our body, the
immune system responds to it through cell-mediated immunity and antibody
production. Because SARS-CoV-2 is a novel virus for humans, initially it
causes an innate immune response that activates an elaborate signaling
cascade using proteins called cytokines (Boechat et al., 2021; Vetter et
al., 2020). Within a week or two of the cytokines’ storm, the adaptive
system becomes active that creates natural antibodies (IgM, IgD, and
IgA). These antibodies interact with the virus and eventually kill or
disable it (Sette et al., 2021). The innate immune response plays a
vital role in B cell development, proliferation, and isotype switching
(Viau et al., 2005). When B. lymphocytes bind to SARS-CoV-2, they divide
and mature into identical cells. Millions of high-affinity SARS-CoV-2
specific antibodies are released into the bloodstream and lymphatic
system by these mature memory B cells. As these SARS-CoV-2 driven
antibodies circulate, they bind to SARS-CoV-2 virus particles and
neutralize them by changing their chemical composition, preventing them
from entering other cells. Concurrent interaction with new virus strains
or booster vaccinations increases the affinity of these antibodies even
further. We believe that this process of SARS-CoV-2-driven B cell
activation is repeated several times in order to sustain the efficiency
of the anti-SARS-CoV-2 antibodies, which could lead to what is known as
”perpetual immunity.” Various pre-existing diseases have been linked to
an increased chance of dying from COVID 19, albeit not all comorbidities
carry the same risk (Callender et al., 2020) . This mechanism of
perpetual immunity development is shown in Figure 1.