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Some Covid-19 Survivors Have Antibodies That Attack the Body, not the Virus

November 2, 2020

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Quiz
Source:

This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19). Photo credit: By CDC/ Alissa Eckert, MS; Dan Higgins, MAM - https://phil.cdc.gov/Details.aspx?pid=23312This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL), with identification number #23312.Note: This file was derived from:  2019-nCoV-CDC-23312.png:, Public Domain, https://commons.wikimedia.org/w/index.php?curid=86444014

Required testing levels are a function of disease spread. The more the cases, the more tests are needed to manage the outbreak. 1) _____ tends to grow exponentially at the beginning of an outbreak, meaning that the number of required tests initially also grows exponentially. If properly targeted testing grows more rapidly than cases, it can be contained.

2: _____ recommends increasing testing until fewer than 10% are positive in any given jurisdiction.

New research found 3) _____ similar to those in lupus and rheumatoid arthritis patients. But patients may also benefit from treatments for those autoimmune diseases. 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 from the virus.

This misguided immune response may exacerbate severe Covid-19. It may also explain why so-called 4) “_____“ 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.

The results were reported Friday on the preprint server MedRxiv, and have not yet been published in a scientific journal. But other experts said 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.

For months it has been clear that the 5) _____ can cause the immune system to run amok in some people, ultimately wreaking more damage to the body than the virus itself. (Dexamethasone, the steroid President Trump took after his COVID-19 diagnosis, has proved effective in some people with severe COVID-19 to tamp down this over-exuberant immune response.

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. When that happens, 6) _____, normally cloistered in coiled bundles inside the nucleus, is suddenly scattered and visible. 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 7) _____ never learn to do this and instead produce autoantibodies that glom onto DNA debris from dead human cells, mistaking them for intruders. Something similar may be happening in patients with 8) _____Covid-19, the research suggests. The authors reported earlier this month that some people with severe Covid-19 also have such unrefined B immune cells. The finding prompted them to explore whether those B cells make autoantibodies. In the new study, the authors looked at 52 patients within the Emory health care system in Atlanta who were classified as having either severe or critical Covid-19, but who had no history of autoimmune disorders. Results showed autoantibodies that recognize DNA in nearly half of the patients. They also found antibodies against a protein called 9) _____ factor and others that help with blood clotting. Among the top half of the most seriously ill patients, more than 70% had autoantibodies against one of the targets tested. Some of the autoantibodies the researchers identified are associated with blood flow problems. If the autoantibodies do turn out to be long-lasting, they may result in persistent, even lifelong, problems for Covid-19 10) _____.

Sources: nih.gov; The New York Times; Wikipedia

ANSWERS: 1) COVID-19; 2) WHO; 3) autoantibodies; 4) long haulers; 5) coronavirus; 6) DNA; 7) B cells; 8) severe; 9) rheumatoid; 10) survivors

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