In a new study, researchers found similarities between the deaths of some COVID-19 patients and those with rheumatic illnesses.
They are testing proven rheumatic treatments to see whether they help against the pandemic virus.
The research was conducted by a team at the University of Alberta.
A substantial proportion of COVID-19 patients admitted to intensive care die of pneumonia due to a cytokine storm, where the body attacks itself rather than fighting off the illness.
The team notes that such storms, whether in patients with COVID-19 or rheumatic diseases, are caused by dysfunctional “natural killer” (NK) immune cells.
They say that SARS-CoV-2, the virus that causes COVID-19, might attack NK cells directly by binding to angiotensin converting enzyme 2 (ACE-2), a receptor on the cells that COVID-19 researchers believe attracts and opens the door to the virus.
Worldwide clinical trials are being carried out to test treatments typically used to treat cytokine storm in patients with juvenile arthritis and other rheumatic diseases.
These include intravenous immunoglobulin, a blood transfusion product prepared from the serum of thousands of healthy or previously infected patients and rheumatic drugs such as tocilizumab and anakinra.
Some researchers in China are even attempting to transplant healthy NK cells.
In a healthy person, natural killer cells are responsible for both turning on and turning off the immune response when a body is attacked by disease, including viruses and even cancer.
Unlike other immune cells (T and B cells), natural killer cells don’t need to be trained or primed to fight infection.
After the NK cells kill the virus-infected cells, the T and B immune cells come along and produce cytokines, making the immune reaction stronger and stronger.
But at a certain time, the immune reaction has to end. Natural killer cells play an important role in finishing that huge attack.
If they don’t work, the cytokine storm goes on and on, and the patient will die.
For those who have not been infected with the virus, the team recommends regular mild to moderate exercise to boost their NK cells. For example, daily step climbing, walking, and weightlifting may help.
If people sit the whole day because they have to be isolated, their NK cell activity goes down. That’s the big warning about the isolation of elderly people who are not allowed to go outside of their rooms.
The lead author of the study is Jan Willem Cohen Tervaert, the director of rheumatology in the Department of Medicine.
The study is published in Autoimmunity Reviews.
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