Common ‘immune signature’ in sickest Covid patients could help guide treatment

An on-going study with Guy’s and St Thomas patients called ‘COVID-IP’ has found a common ‘immune signature’ which could ‘help guide treatment.’

The patients involved in the study have agreed to donate to an infectious disease biobank.

The patients will provide regular blood samples during their Covid-19 treatment where the samples are processed at the trust and analysed in the laboratories at King’s College London and at the Francis Crick Institute.

60 Guy’s and St Thomas patients with Covid-19 have had their blood samples analysed to try to understand why some patients become very ill with the disease.

Researchers have found that many of the sickest patients had low numbers of T Cells – immune system cells.

Some patients cannot mount an effective T Cell response which means there are not enough immune cells to clear the body of virus infected cells.

The remaining immune cells can become misguided and instead cause damage to vital bodily organs.

Project lead Adrian Hayday, who heads the Crick’s Immunosurveillance Laboratory and is Professor of Immunobiology at King’s College London, said:

“The changes we’ve observed in the blood are not subtle and patients with these features seem more likely to experience severe disease, requiring intensive management.

“There’s a lot we still don’t know about this virus, but we have seen that it doesn’t simply discriminate according to age and underlying condition.

“Although in smaller numbers, younger, healthy individuals can also be struck down with severe symptoms.

“The dedication of scientists and medical professionals, drawn from many different countries, who have come together to tackle this issue is incredible, and the speed that they have been able to gather these results is unprecedented.

“We need to be at a point where clinical treatment decisions can be guided by the state-of-the-art knowledge of the immune system.

“Indeed, this is why we’re making our data rapidly and freely available so that it can be used across the world by those investigating new avenues for treatment.”

Dr Manu Shankar-Hari, consultant in intensive care medicine at Guy’s and St Thomas’ NHS Foundation Trust, and NIHR Clinician Scientist said:

“We routinely measure white blood cell counts, including lymphocyte and basophil counts in all hospitalised patients.

“Clearly, our new COVID-IP study highlights the enormous potential to measure the status of very specific types of immune cell involved in fighting the virus.

“Moreover, the study’s identification of detailed T cell deficits offers strong support for an international clinical trial in which we provide patients with recombinant IL-7, a natural drug that promotes T cell function. 

“The trial has been designated an Urgent Public Health COVID-19 Trial by the Chief Medical Officer.”

Another trial has also started at Guy’s and St Thomas of an immune system treatment called interleukin-7.

IL-7 is to boost T Cells in the body to allow very ill patients to better fight off the disease.

The COVID-IP study, which is analysing the immune response of patients with COVID-19 is supported by King’s Together and is ongoing.