Hidden immune weakness found in 14% of gravely ill COVID-19
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People infected by the novel coronavirus can have symptoms that range from mild to deadly. Now, two new analyses suggest that some life-threatening cases can be traced to weak spots in patients' immune systems.

At least 3.5 percent of study patients with severe COVID-19, the disease caused by the novel coronavirus, have mutations in genes involved in antiviral defense. And at least 10 percent of patients with severe disease create "auto-antibodies" that attack the immune system, instead of fighting the virus. The results, reported in two papers in the journal Science, identify some root causes of life-threatening COVID-19, says researchers.

In one study in March, Casanova's team was aiming to enroll 500 patients with severe COVID-19 worldwide in their study. By August, they had more than 1,500, and they now have over 3,000. As the researchers began analyzing patient samples, they started to uncover harmful mutations, in people young and old. The team found that 23 out of 659 patients studied carried errors in genes involved in producing antiviral interferons.

In the second study, the team's analysis of 987 patients with life-threatening COVID-19 revealed just that. At least 101 of the patients had auto-antibodies against an assortment of interferon proteins. These antibodies blocked interferon action and were not present in patients with mild COVID-19 cases, the researchers discovered.

"By testing for the presence of these antibodies, you can almost predict who will become severely ill," says researchers

The vast majority—94 percent—of patients with the harmful antibodies were men, the team found. Men are more likely to develop severe forms of COVID-19, and this work offers one explanation for that gender variability, authors say.

Source: https://science.sciencemag.org/content/early/2020/09/23/science.abd4570
https://science.sciencemag.org/content/early/2020/09/23/science.abd4585
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