By Wayne Marasco, MD, PhD, Professor in the Dana-Farber Department of Cancer Immunology and Virology and Professor of Medicine at Harvard Medical School
Many millions of people around the globe have had COVID-19. The vast majority of people have recovered, but several hundreds of thousands of people have died from the virus. This pandemic has had a profound impact on our lives.
Here is what we’re aiming to learn about COVID-19 — and how you can potentially help aid in the search for a cure or vaccine.
Learning about our immune response to COVID-19
COVID-19 has only been around for about six months, so there is still much that we do not know about how our immune systems fight against SARS-CoV-2 and how the immune system can mount an effective response against the virus.
One area of particular importance is the study of antibodies, proteins in our blood that are released by immune plasma cells in response to infection. Antibodies that bind to spike protein and block virus infection are called neutralizing antibodies.
We do know from the prior SARS (2002-2004) and MERS (2012-present) epidemics that people that have been infected with these two coronaviruses (CoVs) develop neutralizing antibodies to the spike protein. SARS-CoV-2 is coated with spike proteins that serve to attach the virus to airway cells to start the infection, so it stands to reason that this similarity could be exploited.
We know that the levels of these neutralizing antibodies vary from high to very low, and can even be undetectable in some people. Antibodies can last as short as a few months and up to 2 to 3 years in patients.
How can I get involved in help in combatting COVID-19?
Blood samples provide the means for investigators like myself to gain valuable information about the neutralizing antibodies in our blood, their levels and types, and whether these antibodies are specific for SARS-CoV-2, or whether they may have been boosted by a childhood coronavirus infection and show cross-protection.
Most individuals with acute COVID-19 infection will be recruited into COVID-19 studies in the hospital where they are seeking care, if they are sick enough to be admitted to the hospital. These acute blood samples are valuable in identifying anti-COVID-19 antibodies and determining levels of proteins called cytokines, which are released from your immune cells and have pro-inflammatory or anti-inflammatory properties. These proteins can assist in recovery of infection, but when the pro-inflammatory cytokines are released in excessive amounts, they can result in “collateral damage.” They also decrease as you recover.
If you have recovered from COVID-19 but have not been recruited into a study yet, you can have a significant role in helping researchers discover effective vaccines and drugs against the SARS-CoV-2.
Convalescent blood samples (which can be taken 10 days after COVID-19 symptoms have ended) are a rich source of information that can help researchers in many ways. Your antibodies will give us a roadmap of how your body has cleared the infection. This could lead to the development of antibody drugs against COVID-19. They could also aid in the development of a vaccine, as antibody responses are the primary way in which most vaccines against COVID-19 will be measured.
If your anti-COVID-19 antibodies are high enough, you are what we call an “elite responder,” and you may also be able to donate your plasma to help save the life of a person with severe COVID-19.
How do I find a study?
Finding a study that is actively collecting blood samples from people that have recovered from COVID-19 will require some work on your part. Studies are being performed at academic laboratories all over the country, including this one at Dana-Farber, and can likely be found via a web search. Find a study that interests you.
If I had COVID-19, can I get it again?
We do not know if you will be protected from COVID-19 in the future. It will take time to find this answer, which is not likely to be the same for everyone. If your antibody levels remain high, we believe you have the greatest likelihood of being protected. We will only know by measuring your plasma antibody levels over time. If COVID-19 mutates like the flu virus does every year, your antibodies may not be (as) protective.
When will effective anti-COVID-19 drugs or vaccines be developed?
Both anti-COVID-19 antibody drugs and vaccines are under development by many academic investigators and companies. Vaccines are already being tested in healthy people without COVID-19. Antibody drugs are expected to begin testing this summer or fall.
When these treatments will be ready for the population is not clear — but 2021 is possible, at least for some vaccines. Realistically, some regulatory leniency or reform would probably be necessary for this timetable to be further accelerated.
In addition to his roles at Dana-Farber and Harvard Medical School, Wayne Marasco, MD, PhD, is an infectious disease physician and has been a scientist in emerging infectious diseases for many years. He has worked extensively in the field of human coronaviruses and was actively working in the field during the 2002-2004 SARS-CoV epidemic in China and the MERS-CoV epidemic that started on the Arabian peninsula.