New research suggests that SARS-COV-2 may affect the body similarly to Human Immunodeficiency Virus (HIV). As a result, a multi-drug treatment like that which HIV-positive people receive is being considered for an effective medical response for COVID-19 patients.
Researchers have discovered that SARS-COV-2 may cause some essential cells in the immune system to disappear or weaken, which could cause severe harm to patients and their immune response. The New York Times reports that this is similar to how HIV works.
According to Dr John Wherry, an immunologist at the University of Pennsylvania, their research reveals “very complex immunological signatures of the virus”. In a study, he discovered three patterns of immune defects in severely ill COVID-19 patients. The T and B fighting cells, which are crucial in the immune response, were inactive in about 30% of the patients. For these patients, their response to medication and a possible vaccine could thus be implicated.
As a result, instead of a singular medical response, these types of patients might require a cocktail of drugs to treat them, much like HIV patients.
Another study conducted by Dr Adrian Hayday, an immunologist at King’s College London, found that some COVID-19 patients had a marked increase in the levels of IP10, a molecule that sends T cells to where they are needed in the body.
IP10 levels typically only briefly increase to dispatch the T cells, however some patients were experiencing elongated periods where their IP10 levels went up and stayed up. This could create a sort of chaos in the body, as there are constant signals to send T cells, which might confuse them on where to go and thus interrupt the immune response.
If the T cells act differently to how they are supposed to, they can die off which reduces the body’s reserve of T-cells and thus its immune response.
“It’s like Usain Bolt hearing the starting gun and starting to run, then someone keeps firing the starting gun over and over. What would he do? He’d stop, confused and disoriented,” explained Dr Hayday.
This research could also help explain why children are less likely to get sick from COVID-19. The New York Times reports that children have highly active thymus glands, which is where new T cells are produced. As such, they can produce more T cells faster and can help fight off the virus quicker than the virus can affect the cells. People over the age of 40 have reduced functioning of the thymus, which affects their T-cell reserve and thus their immune response.
All this research suggests a treatment model similar to HIV patients may be necessary. A cocktail of drugs could help treat those both with mild symptoms and those who are severely ill.
However, a recent study has found that a combination of antiviral drugs lopinavir and ritonavir, used to treat HIV patients, has no beneficial effect on hospitalised COVID-19 patients. The World Health Organisation has since discontinued the use of these drugs, as well as malaria drug hydroxychloroquine, on hospitalised patients as they have not been proven to reduce mortality rates. However, they will continue to be used on non-hospitalised patients.
Dr Hayday seems positive that COVID-19 can become a manageable disease through the use of effective drugs, with or without a vaccine.
“A vaccine would be great, but with the logistics of its global rollout being so challenging, it’s comforting to think we may not depend on one,” he told the New York Times.