Hidden immune weakness found in 14% of gravely ill COVID-19 patients
By Meredith WadmanSep. 24, 2020
Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.From the first months of the COVID-19 pandemic, scientists baffled by the disease’s ferocity have wondered whether the body’s vanguard virus fighter, a molecular messenger called type I interferon, is missing in action in some severe cases. Two papers published online in Science this week confirm that suspicion. They reveal that in a significant minority of patients with serious COVID-19, the interferon response has been crippled by genetic flaws or by rogue antibodies that attack interferon itself.
“Together these two papers explain nearly 14% of severe COVID-19 cases. That is quite amazing,” says Qiang Pan- Hammarström, an immunologist at the Karolinska Institute. (See link for article)
The article points out that these findings have practical implications from testing to treatments. It also points out that convalescent plasma treatment could harbor the interferon-neutralizing antibodies which in turn could worsen those with the immune weakness.
None of the 663 people in a control group with mild or asymptomatic SARS-CoV-2 infection had those damaging antibodies. The antibodies were also scarce in the general population, showing up in only 0.33% of more than 1200 healthy people tested. “What this means is that at least 10% of critical COVID-19 is an autoimmune attack against the immune system itself,” Casanova says.
One of the authors stated the importance of trying therapies aimed at boosting type I interferon, but others warn that these antibodies could be a consequence rather than a cause of severe illness.
Men are more likely to carry the rogue antibodies.
September 29, 2020