In order to find an answer to the question as to why some Covid-19 cases are more severe than others? A study by investigators at the Stanford University School of Medicine, and at Emory University, the University of Hong Kong, and the Hospital Authority of Hong Kong, has uncovered immunological deviations and lapses that appear to spell the difference between severe and mild cases of COVID-19. These findings of the study reveal how the immune system goes awry during coronavirus infections, leading to severe disease.
As per the study published in Science, on August 11, 2020, the difference may stem from how our innate immune system responds to SARS-CoV-2, the virus that causes the disease. The immune system rapidly senses viruses and other pathogens, after which it immediately launches an indiscriminate attack on them. It also mobilises more precisely targeted, but slower-to-get-moving, ‘sharp-shooter’ cells belonging to the body’s pathogen-defense forces, the adaptive immune system.
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The researchers analysed the immune response in 76 people with COVID-19 and in 69 healthy people. They found increased levels of molecules that aggravate inflammation in the blood of severely ill COVID-19 patients. Three of the molecules they identified are known to cause lung inflammation in other diseases but had not been shown previously in COVID-19 infections. These three molecules and their receptors could represent attractive therapeutic targets in combating COVID-19.
The scientists also found elevated levels of bacterial debris, such as bacterial DNA and cell-wall materials, in the blood of those critically ill COVID-19 patients. The more debris, the sicker the patient—and the more pro-inflammatory substances circulating in his or her blood.
This suggests that in cases of severe COVID-19, bacterial products normally present only in places such as the gut, lungs, and throat may enter the bloodstream and flare up the inflammation, conveying it to all parts through the circulatory system.
Researchers believe that these inflammation-promoting molecules that cause severe disease most likely originate in patients’ lungs, the site of infection.
The study also revealed a paradox in the functioning of the immune system, the worst the case of COVID-19, the less effective certain cells of the innate immune system become in responding to the disease. Instead of launching an attack on the viruses and bacteria, these normally alert cells turn sluggish.
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