By profiling the immune response to the novel coronavirus in critically ill COVID-19 patients, scientists have identified a unique pattern of six molecules which could be used as therapeutic targets for the disease. The researchers from the Lawson Health Research Institute in the UK, assessed blood samples taken from critically ill patients at the London Health Sciences Centre (LHSC). Based on the analysis, published in the journal Critical Care Explorations, the scientists found top six molecules in the blood of COVID-19 positive patients in the intensive care unit (ICU), which distinguished them from those without the disease. According to the scientists, the immune system of some COVID-19 patients overreacts to the virus and causes a ”cytokine storm” in which elevated levels of their body”s natural inflammatory molecules damage healthy cells. “Clinicians have been trying to address this hyper-inflammation but without evidence of what to target,” explained study co-author Douglas Fraser from Lawson and Western’s Schulich School of Medicine & Dentistry. “Our study takes away the guessing by identifying potential therapeutic targets for the first time,” Fraser said. In the research, the scientists assessed 30 participants — 10 COVID-19 patients and 10 patients with other infections admitted to LHSC’s intensive care unit (ICU), as well as 10 healthy control participants. They drew blood from the patients daily for the first seven days of ICU admission, processed the samples in a lab, and then analysed the data using statistical methods. Of the 57 inflammatory molecules that the scientists studied in the patient samples, they found that six were uniquely elevated in COVID-19 ICU patients. These were the molecules tumor necrosis factor, granzyme B, heat shock protein 70, interleukin-18, interferon-gamma-inducible protein 10, and elastase. When the researchers used artificial intelligence to validate their results, they found that the inflammation profiling was able to predict the presence of COVID-19 in critically ill patients with 98 per cent accuracy. The team also found that one of the molecules — heat shock protein 70 — was strongly associated with an increased risk of death when measured in the blood early during the illness. “Inflammation profiling predicted COVID-19 status with 98 per cent accuracy, whereas elevated heat shock protein 70 was strongly associated with mortality,” the scientists noted in the study. According to Fraser, understanding the immune response is paramount to finding the best treatments for COVID-19. Citing the limitations of the study, the researchers said they only studied a small number of patients, and could not determine the inflammatory changes contributing to ICU admissions. “Our next step is to test drugs that block the harmful effects of several of these molecules while still allowing the immune system to fight the virus,” Fraser added.
