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)
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**Comment**
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.
Important excerpt:
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.
doi:10.1126/science.abe9395
September 29, 2020
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