COVID-19 and Who It Effects Severely

Although some of those patients who are severely affected by Coronavirus are of an increased age and people with pre-existing health conditions such as high blood pressure, diabetes and obesity, this is not always the case.  The relatively young and generally healthy appear to be less at risk but not all of them.

So why does one healthy young person contract the Coronavirus and get admitted and find themselves on a ventilator whilst another person gets through the infection almost symptom free.  Why do some people not catch it at all?  Why at a contained meeting does not everyone get infected?

Genes must play a part.  However, how is this then translated into treatment or improved outcomes in those infected?  Early studies not yet published suggest that variations in the HL ageing could play a role.  HLA tells the body how to make specific proteins that the immune system uses to recognise viruses and bacteria that enter the body.  These are then targeted and killed. 

Researchers at Oregon Health and Science University have developed a computer model which suggest that variations in this gene between one person and another can result in proteins that are better or worse at recognising and dragging for coronavirus in the body.  This theory was checked against previous genetic research in people who had severe acute respiratory syndrome, SARS, caused by the coronavirus during the outbreak of 2002 to 2004.  Patients who had certain versions of HLA had more severe SARS infection and more of the virus in their bodies that those with different versions. 

This, however, was a computer simulation and needs to be confirmed by human studies.

The TMPRSS2 gene is another possible suspect.  This gene is also involved in influenza infection and helps to create a protein which the Coronavirus uses to get inside human cells.  Some patients produce high levels of this protein, others much less.  Researchers needed to prove that people who produce less of the protein do much better with COVID-19 infection. 

The ACE2 gene as well helps to produce ACE2 receptors on the surface of human cells.  The Coronavirus plugs onto these ACE2 ports so it can actually latch into cells. 

This gene clearly needs to be studied.  It is therefore important to look at patients who have been exposed to the Coronavirus again and again but based on antibody testing, never contract it.  This might suggest that they are intrinsically resistant to the infection. 

Also, what about someone who is under 50, runs marathons but is now intubated on intensive care.  What is it about this type of patient which led him to have serious COVID-19 disease. 

Research has shown that it is possible for genes to make you immune to infectious diseases.  Immunity has been found to HIV, Norovirus as a result of genetics. 

Casanova MD, a professor at Rockefeller University and Sue, Chief of the Human Immunological Disease Section at The National Institute of Allergy and Infectious Diseases in America are collecting DNA samples from 100s of COVID-19 outliers.  They are reviewing their genetic code to see if any of these unusual cases have any gene variants or mutations in common.  Unfortunately, often genetic studies do not provide the answer but only time will tell.

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