Covid-19 immunity and immunopathology – testing and mechanisms
Gitta Stockinger, Caetano Reis e Sousa, George Kassiotis, Adrian Hayday, Anne O’Garra, Samra Turajlic, Rupert Beale, Andreas Wack, Veni Papayannopoulos
How can we tell who’s already had the virus?
The Crick/UCLH/UCL serology initiative has developed a blood test to indicate whether someone has been infected with SARS-CoV-2.
The Crick’s expertise in flow cytometry and neutralisation assays (tests that measure how effective different antibodies are at preventing infection), offer a high level of accuracy and provide powerful insights into patients’ immune response to infection.
The information from our tests could be used to quickly determine the effectiveness of candidate vaccines. It will also be used for research studies seeking to establish levels of infection across large groups of people and to find out how long immunity to SARS-CoV-2 might last.
Find out more about coronavirus antibody tests and what we know so far.
Why are some cases much worse than others?
Patients who die of COVID-19 often succumb to pneumonia, leading to respiratory failure. Many of these patients are older or have existing health conditions, but some younger, healthy individuals decline rapidly after infection.
Some patients suffer from overreactive immune responses. We need to understand the causes and consequences of excessive immune responses. Our researchers are using their substantial expertise in inflammation research, tissue repair and virology, to study why some people can’t get rid of the infection after a few days and why some people enter a type of ‘immune shock’ where inflammatory cells cause the body to shut down.
Watch our Instagram Q&A to meet one of our researchers and explore our work to understand the immune response to SARS-CoV-2.
How do we know who may need intensive care?
The Crick, King’s College London and Guy's and St Thomas' NHS Foundation Trust have built a high-throughput platform, looking at patient’s blood over time to see how our immune system responds to coronavirus, and if there are clues to whether someone might need additional treatment.
The team has previously run large studies monitoring how people’s immune systems respond to flu vaccines, and have developed new methods for tracking patients’ immune response. In the new platform, they are identifying so-called ‘immune response markers’ that differentiate patients according to their disease severity.
The results have led to a collaborative study with public health statisticians, to investigate if those ‘markers’ offer an improved way for doctors to predict which patients are likely to need intensive care and to get them the treatment they need faster. The results are expected in February 2021.
The team’s approaches are also being used to test whether COVID-19 vaccines are effective in cancer patients, who need to visit hospitals frequently, but who are often considered to have weak immune systems.
Find out more about the COVID-IP project.
What are the threats from the new SARS-CoV-2 variants?
The Crick is investigating the degree of cross-reaction and cross-protection between the new variants, and also between common cold coronaviruses and SARS-CoV-2. We are specifically investigating if immunity, induced by infection or vaccination with the original strain, can protect against new variants. Currently, we are focussing on the new variants that emerged in the UK, South Africa and Brazil.
We are also preparing for further mutations and new variants of SARS-CoV-2 that may not respond to the current vaccines, or for future zoonotic (spread between animals and people) introductions of novel coronaviruses.
We are testing a vaccine in preclinical models that trains the immune system to recognise all coronaviruses and variants thereof - a pan-coronavirus vaccine. This is based on our earlier discovery that some antibodies, created during infection with common colds, can also target SARS-CoV-2.
Find out more about the national research project to study the effects of emerging SARS-CoV-2 variants.