Hidden Immune Weakness Found in 14% of Gravely Ill COVID-19 Patients

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https://www.sciencemag.org/news/2020/09/hidden-immune-weakness-found-14-gravely-ill-covid-19-patients

FILE PHOTO: A medical staff member is seen next to a patient suffering from the coronavirus disease (COVID-19) in the intensive care unit at the Circolo hospital in Varese, Italy April 9, 2020. REUTERS/Flavio Lo Scalzo/File Photo (Newscom TagID: rtrltwelve088472.jpg) [Photo via Newscom]

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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Author: uwe.roland.gross

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