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Of: TT
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Photo: LEIF R JANSSON / TT
The level of certain immune cells appears to show how severely a patient with COVID-19 is at risk of becoming ill. Stock Photography.
In a unique study, Swedish researchers have studied the immune response in covid patients during the course of the disease. Preliminary results show that there may be some form of markers in the blood that reveal the severity of a patient’s illness early on.
When the first COVID-19 patients began to appear after sports holidays, immunologist Anna Smed Sörensen and her research group at the Karolinska Institutet were prepared. For several years, they have been conducting a study in collaboration with the Karolinska University Hospital, where they took blood samples and samples from the respiratory tract of patients with influenza who came to medical attention. Now the research team could easily switch and instead start collecting samples from patients infected with the new coronavirus in a systematic way.
– We understood that this would be great, so after a risk assessment we decided to start, says Anna Smed Sörensen, immunologist and research group leader at Karolinska Institutet.
Blood analysis and analysis
The more than 160 patients who consented to participate in the study had to present blood and airway samples at the first encounter. Thereafter, the research group followed the patients throughout the course of the disease, with continuous samples and examinations.
In this way, the researchers have collected a sample material more or less unique in the world, which gives a picture of how the immune response reacts in covidual patients with everything from symptoms so mild that they do not know they are sick, to patients who they have very serious complications, and in some cases, patients who become so seriously ill that they do not survive.
– The general question of our project is to understand how it is that the same virus causes such different degrees of disease and what role the immune system plays. Simplified a bit, it can be said that the collective research indicates that those who get very sick often do so because the immune system overreacts and begins to damage the body’s own cells, says Anna Smed Sörensen.
High content
Now that the researchers have performed a first analysis of the samples, a pattern emerges: In people who were very seriously ill, there were clearly elevated levels in the blood of a cell type called myeloid suppressor cells. In addition, the researchers were able to see that an elevated level already in the first blood tests was associated with a more serious progression of the disease.
– We also see that the level is elevated in patients with influenza. But in the covid patients, there were very high levels in the blood, says Anna Smed Sörensen.
Myeloid suppressor cells are a type of immune cell that slows down the activity of T cells, the part of the immune system that, among other things, attack cells infected by viruses. However, Anna Smed Sörensen does not interpret the result to mean that it is only the braking effect that makes patients seriously ill. Rather, elevated levels are a sign that the immune system is out of balance.
– What you see is that there is a complete boost in all parts of the immune system, it seems to be completely poorly regulated. There is a lot of gas and very little brake. So despite having high levels of myeloid suppressor cells, the inflammatory response is very strong, says Anna Smed Sörensen.
The correct scenario
She emphasizes that the results should be considered preliminary, as the study has so far only been published as a preprint on the Medrxiv site pending publication. But she believes the connection is credible, and it is also in line with similar observations from other research groups.
Being able to predict early on which patients will become seriously ill is something of an illusion in medical care. Especially when it comes to a disease for which there is no cure yet. Then the treatments that are still available can be started as soon as possible and at the correct stage.
– Our data suggest that this could be a marker to help decide where to put gunpowder when healthcare is severely affected. So I wouldn’t say that I would use it as the sole marker, but this can be an important step along the way and also contribute to our better understanding of the course of the disease, says Anna Smed Sörensen.
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