A track to identify patients at risk of having a severe form of the COVID-19

Une piste pour repérer les patients à risque d’avoir une forme grave de la COVID-19

Photograph: Xavier Galiana Agence France-Presse
An intensive care unit at the hospital Sharda, in the city of Greater Noida, near New Delhi, India

A study by French researchers shows that the deficit in the blood of a protein that is normally produced by the immune system ” could be the mark of the serious forms of COVID-19 “, a result which could help to identify patients at risk.

“The deficit in interferons of type 1 in the blood could be a signature of severe forms of COVID-19 “, concludes the study published this week in the american journal Science.

Interferons are proteins of the family of cytokines produced especially by the cells of the immune system in response to the presence of an infection.

Approximately 5 % of people with the COVID-19 evolve into a form of serious or critical, with severe pneumonia transforming into acute respiratory distress syndrome, which often occurs 9 to 12 days after the onset of the first symptoms of mild to moderate.

The researchers believe that this increase is caused by a surge in cytokines, which causes a runaway of the “inflammatory response” of the body. But the doctors do not know precisely which patients will develop the severe form of the disease, beyond the risk factors observed (diabetes, obesity, advanced age, etc)

However, it is” a key issue […] to improve the individual care and the prognosis of these patients, ” observed Thursday in a press release from Inserm, the University Paris, Institut Imagine, the public Assistance-Hospitals of Paris and the Pasteur Institute.

The authors of the study, from these agencies, have performed analyses on 50 patients with the COVID-19, with varying degrees of severity different.

It appears that in critically ill patients, ” the production and activity of interferons type 1 are greatly diminished “. They also have ” a viral load blood persistent, showing poor control of viral replication by the immune system of patients and leading to runaway of an inflammatory response to be ineffective and pathological.”

The study also reveals that ” low levels of interferon type 1 in plasma precede the increased clinical severity of patients and their transfer to an intensive care unit “. Therefore, the deficiency of the interferon type 1 ” could be a signature of severe forms of the COVID-19 and could identify a high-risk population “.

In addition, these results underline the interest of therapeutic approaches involving the early administration of interferon with an anti-inflammatory therapy adapted […] in patients in prevention of a severe form “, conclude the authors.

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