Sun Sentinel Broward Edition

Some survivors have immune issues

- By Apoorva Mandavilli

Some survivors of COVID-19 carry worrying signs that their immune system has turned against their own body.

NEW YORK — Some survivors of COVID-19 carry worrying signs that their immune system has turned on the body, reminiscen­t of potentiall­y debilitati­ng diseases like lupus and rheumatoid arthritis, a new study has found.

At some point, the body’s defense system in these patients shifted into attacking itself, rather than the virus, the study suggests.

The patients are producing molecules called “autoantibo­dies” that target genetic material from human cells, instead of fromthe virus.

This misguided immune response may exacerbate severe COVID-19. It may also explain why so-called long haulers have lingering problems months after their initial illness has resolved and the virus is gone from their bodies.

The findings carry important implicatio­ns for treatment: Using existing tests that can detect autoantibo­dies, doctors could identify patients who might benefit from treatments used for lupus and rheumatoid arthritis. There is no cure for these diseases, but some treatments decrease the frequency and severity of flare-ups.

“It’s possible that you could hit the appropriat­e patients harder with some of these more aggressive drugs and expect better outcomes,” said Matthew Woodruff, an immunologi­st at Emory University in Atlanta and lead author of the work.

The results were reported Friday on the preprint server MedRxiv, and have not yet been published in a scientific journal. But other experts said that the researcher­s who carried out the study are known for their careful, meticulous work, and that the findings are not unexpected because other viral illnesses also trigger autoantibo­dies.

“I’m not surprised, but it’s interestin­g to see that it’s really happening,” said Akiko Iwasaki, an immunologi­st at Yale University. “It’s possible that even moderate to mild disease may induce this kind of antibody response.”

For months it has been clear that the coronaviru­s can cause the immune system to run amok in some people, ultimately wreaking more damage to the body than the virus itself.

Viral infections cause infected human cells to die. Sometimes the cells die a quiet death — but sometimes, and especially in the throes of severe infection, they can blow up, strewing their innards.

In the typical response to a virus, cells known as B immune cells make antibodies that recognize pieces of viral RNA from the virus and lock onto them. But in conditions like lupus, some B cells never learn to do this and instead produce autoantibo­dies that glom onto DNA debris from dead human cells, mistaking them for intruders. Something similar maybe happening in patients with COVID-19, the research suggests.

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