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- A significant portion
of those infected with the new coronavirus
may not show any symptoms at all.
And even in those who develop symptoms,
the majority of cases will be mild.
But we also know that some people
get severely ill from COVID-19.
So why do people react
differently to the virus
and which category do you fall under?
- It is thought that it is really
the overdrive of the immune response
that's leading to the
severe cases of COVID-19.
- [VO] Dr. Iwasaki and her colleagues
are trying to decipher the difference
between a protective versus
a pathologic immune response
to COVID-19.
- In a normal immune response,
what happens is that the
immune response kicks in
and it starts to recruit
cells from the blood,
known as the white blood
cells, to clear the virus.
But in certain patients,
what we're seeing is that
the immune system actually
goes into overdrive.
Instead of simply
getting rid of the virus,
the immune system starts
secreting cytokines.
This is known as the cytokine storm.
And instead of helping the
host cope with the infection,
the cytokines actually can
cause damage to the tissue,
such as breaking down protective lining
of the lung and the blood vessels.
- [VO] These cytokine storms
were historically
responsible for many deaths
during the 1918 flu pandemic
and other viral outbreaks
and they're probably behind
the most severe cases of COVID-19.
- [Dr. Iwasaki] Right now, we don't understand
what kind of immune responses are needed
to recover from the infection,
versus what types are
driving the disease itself.
- [VO] Although the results are preliminary,
her team's research has already
unearthed important clues.
- We are seeing elevated
cytokine levels in the blood
in the patients that go
on to progressive disease
compared to those that
recover from the infection.
The other thing we're seeing is that
lymphocytes acquire
this exhausted phenotype
in the patients that go
on to progressive disease
and ultimately, the lymphocyte
becomes depleted from the patient
and that is obviously not a good news
because a person becomes
immunocompromised at that stage.
So we're trying to understand
how these things happen
in the COVID-19 patients.
- [VO] This research
could provide clinicians
with biomarkers they could use
to better predict how
an individual patient
will respond to the virus.
But that's not all.
- The other outcome we're
hoping to also obtain
are the insights that are
needed for better therapy
in patients that are
suffering from severe disease.
Ultimately, we want to understand
what type of immune
response we need to suppress
so that the patients actually
can recover from severe disease.
- [VO] Ongoing research is revealing
more about this virus every day.
But in the meantime, Dr.
Iwasaki has some advice.
- Even though research is showing
different aspects of the
immune response to the virus,
we still don't have a
vaccine or therapeutics
that can prevent the
spread of the disease.
So social distancing
and also washing hands
and really keeping a healthy lifestyle
so that your immune system
is as optimal as it can be.
I know this is difficult for many people
because they're under such stress
from this COVID-19 outbreak,
but it's really important
to keep a self-care.
