Case Study Maps Covid-19 Immune Response

(Gerd Altmann, Pixabay)

17 Mar. 2020. Infectious disease specialists in Australia tracked the course of an early patient’s immune-system response to non-severe novel coronavirus, or Covid-19, infections. Researchers from University of Melbourne describe their findings in a letter to the journal Nature Medicine, published in yesterday’s issue.

A team from the Peter Doherty Institute for Infection and Immunity at University of Melbourne gained access to a patient at Royal Melbourne hospital with a Covid-19 infection, who agreed to be the subject of the study. The individual, a 47 year-old woman from Wuhan, China, arrived in Australia 11 days before checking in at the hospital with symptoms including a dry cough, chest pain, fever, and lethargy. She was otherwise healthy, a non-smoker, and had no contact with Wuhan’s seafood market, where early cases of Covid-19 are believed to begin, nor any other people known to have Covid-19 infections.

The patient was screened using Melbourne’s research platform for screening travelers with suspected infectious diseases. The system known as Sentinel Travellers and Research Preparedness for Emerging Infectious Disease, or Setrep-ID, was put in place to detect and characterize infectious diseases brought into the country by travelers. Infectious disease physician Irani Thevarajan is one of the researchers that developed Setrep-ID, and leader of the team that evaluated the patient.

“When COVID-19 emerged,” says Thevarajan in a university statement, “we already had ethics and protocols in place so we could rapidly start looking at the virus and immune system in great detail.” Thevarajan adds the team plans to expand its use nationwide in Australia from its beginnings in Melbourne.

Hospital physicians detected Covid-19 in the patient by reverse transcriptase–polymerase chain reaction, or RT-PCR, analysis of nasal swab specimens. Subsequent blood and other specimen tests showed a response from the person’s immune system, starting with an increase in antibody secreting cells. The researchers also found production of more helper, CD4+, and CD8+ T-cells, as well as immunoglobulin M and G antibodies in the patient’s blood. The team detected these immune-system cells while the person still had Covid-19 symptoms, which continued for seven days after her symptoms were resolved.

The individual did not experience complications or severe forms of Covid-19 infections, such as acute respiratory distress syndrome, nor required supplemental oxygen, and was released from the hospital within a week.

Immunologist Katherine Kedzierska, director of the lab conducting the research and senior author of the paper, notes, “We showed that even though COVID-19 is caused by a new virus in an otherwise healthy person, a robust immune response across different cell types was associated with clinical recovery, similar to what we see in influenza.” She adds, “People can use our methods to understand the immune responses in larger COVID-19 cohorts, and also understand what’s lacking in those who have fatal outcomes.”

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