Immune system markers correlate with COVID-19 disease severity

New research from Brown University has identified possible biomarkers to help predict severity of SARS-CoV-2 disease. The accepted version of the study was published on January 14, 2021, online in the journal eLife.

Cytokine storms, where the body’s immune system attacks its own cells and tissues instead of only fighting off a virus, have been shown to occur in people with severe COVID-19. To better understand this phenomenon, the researchers assessed cytokine blood levels in donor and patient samples grouped by a COVID-19 Severity Score (CSS), which was based on clinical markers such as whether the patient was hospitalized and required supplemental oxygen. Correlating these levels could help physicians determine when and if patients will need more aggressive interventions.

The researchers found that SARS-CoV-2 infection causes numerous changes in cytokine profiles. In severely ill patients, these changes are consistent with the presence of Macrophage Activation Syndrome (MAS), a massive inflammatory response that overwhelms the entire body and can lead to death. The cytokine most relevant in predicting CSS was M-CSF, which is secreted by cells in response to viral infection and stimulates production of macrophages. 

Focusing on MAS could be helpful as intensive care units across the country fill up with COVID-19 patients, says the study’s senior author Wafik El-Deiry, MD, PhD, FACP, the Mencoff Family University Professor of Medical Science at The Warren Alpert Medical School of Brown University.

Steroids such as dexamethasone are being used in tamping down the cytokine storm but monitoring MAS or targeting it more specifically could also be helpful.

The plasma samples used in the study were from the Lifespan/Brown COVID-19 Biobank at Rhode Island Hospital, a biorepository of specimens from patients with positive and negative tests for the SARS-CoV-2 virus. The biobank was supported by the Advance-CTR research hub and is available statewide for COVID research.

Brown University’s seed funds for COVID research provided funding for the project. 

The study co-authors include Kelsey E. Huntington, a graduate student in the Pathobiology Program at Brown University; Anna D. Louie, MD, a resident in the Department of Surgery at The Warren Alpert Medical School; Chun Geun Lee, MD, PhD, professor of molecular microbiology and immunology at Brown; Jack A. Elias, MD, dean of medicine and biological sciences at The Warren Alpert Medical School; and Eric A. Ross, PhD, assistant vice president of biometrics and information sciences at Fox Chase Cancer Center.