Rheumatologists at the University of Alberta are flagging similarities between the deaths of some COVID-19 patients and those with rheumatic illnesses, and are testing proven rheumatic treatments to see whether they help against the pandemic virus.

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, said Jan Willem Cohen Tervaert, director of rheumatology in the Department of Medicine.

In a new paper published in Autoimmunity Reviews, Cohen Tervaert and his colleagues note 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.

“This virus is so smart, it kills the cells that are supposed to kill it,” Cohen Tervaert said.

Trials with rheumatoid treatments

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.

Cohen Tervaert said the U of A team is collaborating with researchers at the University of Calgary to further study the role of NK cells in COVID-19 patients. There are more COVID-19 patients in southern Alberta than in the Edmonton area.

Image Credit: Uni. of Alberta

Thanks to Heinz V. Hoenen.  Follow him on twitter: @HeinzVHoenen

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