Crowdfunding has started at UMC Utrecht for a study to provide more insight into the immune system of patients with COVID-19. This allows doctors to better predict the severity of the infection and the disease course per individual patient. Hence, they can also treat patients with the best available medicines, aimed at preventing further damage.

In several studies, UMC Utrecht is investigating options for better treatment of patients with coronavirus disease 2019 (COVID-19). Since it will take some time before a vaccine or new drug becomes widely available, it is extremely important to quickly investigate whether patients with COVID-19 can be adequately treated with currently available drugs. However, this requires more specific knowledge of the immune system.

Immune storm

In order to defeat the coronavirus, in-depth research into the immune system is crucial. In an attempt to fight the virus, in some patients the immune systems is disrupted and becomes hyperactive. This leads to a so-called "cytokine storm". The body produces far too many immune factors. Although those immune factors fight the virus, too much of these causes significant damage to vital organs such as the lungs. As a consequence, patients experience breathing difficulties, have to be admitted to intensive care unit (ICU) for ventilation and can even die.

Mapping the immune response

Under the leadership of physician-microbiologist Prof. Marc Bonten (Department of Medical Microbiology) and medical immunologist Dr. Stefan Nierkens (Center for Translational Immunology), UMC Utrecht is investigating what could cause the immune system to become so disrupted and causing some patients to die. By mapping the early changes in the immune system in a large group of COVID-19 patients, they try to predict the course of the disease. Analysis of the immune system is performed by measuring inflammatory proteins in the blood and markers on the surface of immune cells. They do this research in the blood of patients who have COVID-19.

Tailor-made treatment

The researchers intend to use the outcome to predict who will be affected by the coronavirus and who will not. A 'fingerprint' can then be made for each individual patient, indicating which part of the immune system must be inhibited. A number of medicines are available that can suppress specific parts of the immune system (so-called immune suppressants), which provide tailor-made treatment for patients with COVID-19.

The main features of the study at a glance:

• The study can start immediately in a well-equipped laboratory with the specific expertise in place;
• The results will be available quickly (within a few months);
• The severity of the infection and the course of the disease can be better predicted per patient;
• Patients receive the best available medicine on the basis of a biological basis, which prevents (further) damage;
• The insights gained enable doctors to act faster and more effectively in future (new) infectious diseases.

"In anticipation of widely available vaccines and antiviral drugs, many new patients with severe symptoms due to COVID-19 will unfortunately be admitted to hospitals in the coming period," said Marc Bonten. “Through our research, we gain more insight into the functioning of the immune system in COVID-19. This allows us to offer patients tailor-made treatment using existing medicines.”