FM December 2020 digital P

guide physicians worldwide to identify
effective treatment options using drugs
like hydroxychloroquine and camostat
for COVID-19. Clinical studies have
reported that incidence and mortality
rates are significantly different between
male and female COVID-19 patients.
These studies also proved that the
severity of COVID-19 is associated with
pre-existing conditions, such as cancer
and cardiovascular disorders. It can
be more detrimental in patients with
hypertension receiving anti-hypertensive
medications. Therefore, researchers
propose a systematic investigation of
the functional polymorphisms in ACE-2
and TMPRSS-2 among different human
populations, such as, African/African-
American, Latino/Admixed American,
Jewish, East Asian, Finnish, Non-Finnish
European, South Asian, etc. They believe
that it could pave the way for precisely
formulated personalized medicine and
genetics-based treatment strategies
for COVID-19. Systematic identification
of host genetic pathways and DNA
polymorphisms can modulate the risk
of infection and severe illness, including
the over-exuberant immune response
to the virus that makes the patient’s
condition worse.
Genetics of Interferon
and COVID-19
What makes individual responses
to COVID-19 drugs so different in
their efficacy from person to person?
Researchers from University of Paris,
Rockefeller University and Howard
Hughes Medical Institute in New York,
in collaboration with some other teams
across the world, have answered this
key question for the first time. They
found that some patients have a defect
in the activity of type-I interferons,
the molecules of the immune system
that normally act against any kind of
viral activity. The researchers propose
that their discoveries would make it
possible to detect people who are
at a high risk of sustaining serious
repercussions from COVID-19. The
results of the study, published in the
journal Science, describe genetic
AUTOANTIBODIES— KEY TO
COVID-19 PNEUMONIA
The higher amount
of autoantibodies
produced by type-I
interferon are capable
of neutralizing the
effect of the anti-
COVID-drug molecules
ALL THE EVENTS THAT
HAPPEN AT A MOLECULAR
LEVEL ARE CONCERNED
WITH AROUND 13 GENES
WHICH GOVERN THE TYPE-I
INTERFERON-CONTROLLED
IMMUNE RESPONSE
abnormalities in patients with severe
forms of COVID-19. All the events
that happen at a molecular level are
concerned with around 13 genes which
govern the type-I interferon-controlled
immune response against the influenza
virus. Mutations in these genes can
cause the production of defective
type-I interferon which can lead to
severe forms of influenza. Surprisingly,
these genetic variants are also
present in adults who have not
previously been particularly ill with
influenza.
Regardless of age, people with
these mutations in their genes
governing the type-I interferon are at a
10%
of patients
develop severe
pneumonia due to
a SARS-CoV-2
greater risk of developing a potentially
fatal form of influenza or COVID-19.
But there is a quick and simple way
to detect these high-risk groups of
patients: By conducting a ‘Serum IFN
type-I Assay’ using the ultra-sensitive
digital ELISA technique. The earlier the
test is conducted, the better will be the
therapeutic prospects of the patient.
In the second study, also published in
Science, researchers stated that they
could identify a high level of antibodies
in the blood of patients with severe
forms of COVID-19. The higher amount
of autoantibodies produced by type-I
interferon are capable of neutralizing
the effect of the anti- COVID-drug
molecules. These researchers found
that the autoantibodies are found
in more than 10% of the patients
developing severe pneumonia due to
a SARS-CoV2- infection. However, they
are absent in people who develop
a mild form of the disease, and are
also rare in the general population.
These kinds of patients could benefit
from plasmapheresis (removal of the
liquid portion of the blood containing
white blood cells and antibodies), and
other treatments that may reduce
66 / FUTURE MEDICINE / December 2020