Among COVID-19 coronavirus patients who are not asymptomatic, symptoms can range from slight fatigue to Acute Respiratory Distress Syndrome (ARDS.) Among those with severe symptoms, is there a common hallmark? Can knowing that factor help doctors predict who will suffer severe symptoms? A new study hopes to answer those questions.
Many doctors have been baffled by some of the odder symptoms suffered by COVID-19 patients. In previous articles (Doctors Share COVID-19 Effects Outside The Lung and What Autopsies Are Telling Us About COVID-19 Coronavirus) I’ve covered some of these at length.
What has also kept doctors scratching their heads is the broad range of symptom severity across the spectrum of patients they are treating for the virus. While most of the worst symptoms are exhibited by patients who are over 60, that’s not an exclusive club and age is no guarantee of a bad COVID-19 experience.
So one big group of scientists from a variety of French institutions performed a research study to try and find the common factor across severe to critical COVID-19 patients. Their findings were published in the journal Science.
The team studied fifty patients in French hospitals. The patients had a variety of symptoms ranging from a minor cough to patients requiring a ventilator. They believe they have found their severe COVID-19 hallmark.
Finding this factor will help doctors understand the reasons for very different reactions to the virus across patient populations, say the researchers. Even with age differences and pre-existing conditions factored in, predicting symptoms across these populations has been challenging.
The researchers analyzed blood, immune cells and other tissues from all the patients. They believe the hallmark of severe to critical cases is found in a combination of very high levels of inflammation and an interferon response. They believe this finding may lead to drug therapies focused on boosting interferon response to COVID-19 and other infections while at the same time reducing inflammation.
To be more precise, their findings were that critically ill patients showed a deficiency in type 1 interferon response. This is a type of protein which the immune system employs to fight infections. They also observed abnormally high levels of proinflammatory signaling in the severe to critically ill patients.
This combination left patients with significantly reduced ability to fight off the COVID-19 infection. Previous research has shown that the location, timing and duration of interferon exposure to COVID-19 are very important in treatment of the virus. These factors seem to be involved in most currently successful therapies. Previous work has also shown that interferon signaling in areas of infection plays a role in halting disease progression.
Interferon and all the factors surrounding it’s positive effects on the virus, would seem to play an important role in beating the SARS-CoV-2 virus. Testing patients with moderate symptoms for type 1 interferon response deficiency may allow doctors to predict who will progress to severe and critical stages. The right therapies at the right time may prevent that progression all together.
Keeping more COVID-19 patients from progressing to advanced symptom stages would mean fewer ICU visits, less ventilation and fewer deaths. I think we can agree that would definitely be a good thing.
Keep the faith and keep after it!
Journal Reference – Jérôme Hadjadj et al, Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients, Science (2020). DOI: 10.1126/science.abc6027