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Licensed Unlicensed Requires Authentication Published by De Gruyter January 7, 2022

Antibody-dependent enhancement of virus infection and disease: implications in COVID-19

  • Ajay Kumar Shukla and Saurav Misra EMAIL logo


Antibody-dependent enhancement (ADE) can be seen in a variety of viruses. It has a deleterious impact on antibody treatment of viral infection. This effect was first discovered in the dengue virus, and it has since been discovered in the coronavirus. Over 213 million people have been affected by the rapid spread of the newly emerging coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). The new coronavirus offers a significant threat and has sparked widespread concern. ADE in dengue virus and other viruses are discussed with possible effect on COVID-19 treatment and vaccine development will need to consider this phenomenon to ensure it is mitigated and avoided altogether. In these case scenarios, the role of ADE and its clinical consequences remains to be explored for this newly detected virus.

Corresponding author: Dr. Saurav Misra, Senior Resident, Department of Pharmacology, AIIMS Bhopal, Bhopal, India, E-mail:

  1. Research funding: None.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Yes, all authors state that there is no conflict of interest.

  4. Informed consent: Not required.

  5. Ethical approval: No requirement of ethical approval.


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Received: 2021-08-27
Accepted: 2021-12-20
Published Online: 2022-01-07

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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