• As we have been hearing routinely throughout past weeks, up to 25%of covid-19 infected people don’t experience symptoms at all and may never know that they have been infected.
• For everyone, key symptoms center around lungs, where patients experience lung failure requiring artificial ventilation. Some patients experience gastrointestinal symptoms.
• Kidney injury, bone marrow reduction and severe heart damage is also seen.
• Cancer doctors who have been studying the immune system for the last two decades recognize the symptoms of COVID-19 infections from their oncology.
• Their thinking is that when key elements of the immune system are kick started by the virus, an ambitious immune response in some patients will lead to life threatening, multi-organ failure.
• If this explosive blast of immunity occurs early enough in the infection, they reason, the patient may die before the virus has the chance to be fully cleaned from the body.

WHAT WE KNOW

• The short answer is that no one know anything with certainty and for that reason we must interpret the following with the caution.
• Symptoms in seriously ill COVID-19 patients resemble familiar symptoms in the settings of other viral infections and cancer.

CYTOKINES

• Many clinicians are observing high serum levels of key cytokines like IL-6 and IL-1, in sickest patients with COVID-19.
• The running hypothesis then is that cytokine release usually a necessary element of the normal response to viral infections, becomes unacceptably high in some patients for reasons that are poorly understood.

CELLULAR IMMUNITY

• The response of activated T cells of the virus is traditionally thought to be a key component of the immune response to the virus.
• However, enhancing T cell immunity with T cell checkpoint blockers in cancer patients can also cause life-threatening inflammation in the lungs, the same type of pneumonitis that is seen in COVID-19 patients.
• It could be that direct lung damage by the virus at the point of entries in the respiratory tract increases the sensitivities of that tissue to the adverse effects of T cell stimulation, and are there already bacteria in the lung micro biome in some patients that predispose them to damage by an active anti viral T cell response.

THE TIMING OF THE VARIOUS IMMUNE RESPONE MAY MATTER

• In the normal response to an infection like COVID-19, all elements of the immune system may be important system, can directly clear virus and/or mark virally infected cells for destruction.
• T-cell stimulation, a second pillar, causes a direct attack on virally infected cells, as it does for cancer cell cytokines.
• Third pillar play role as non-specific overarching stimulator of immune function.
• Each arm of immune system causes different constellation of symptoms depends on the magnitude of response. Each arm is activated at different times in immune response.

PLASMA THERAPY

• Among the myriad clinical trials for vaccines to prevent COVID-19 and drugs to treat infections, doctors are looking to survivor’s plasma for a possible therapy. The FDA stated that the investigators can request to use plasma from COVID survivors to deliver antibodies to seriously ill patients.
• Convalescent plasma treatment, as it is known, has roots stretching back over 100 years.
• It is based on premise that

-Because a survivor developed antibodies throughout the course of their own infection, blood donators to those who became recently ill crowd give recipient’s immune system a leg up reducing the severity of disease and increase survival.

• With a vaccine for COVID-19 still a long way from being realizes ,immunologist are working to revive a century old blood derives treatment for use in the united states in hopes of slowing down the spread of the disease.
• The technique uses antibodies from the blood plasma or serum of people who have recovered from COVID-19 infections to boost the immunity of newly infected patients.
• These antibodies contained on the bloods serum have ability to bind to and neutralize SARS-COV4 the virus that causes COVID-19.

IMMUNOTHERAPY TREAT COVID-19

• When our immune system in response to infection, over production of certain molecules involved in normal immune function can result in a dangerous condition called cytokine release syndrome. CRS is characterized by systematic hyper inflammation that damages patients own tissue, potentially leading to organ failure and death.
• Initially observed in cancer patients whose immune system rejected transplants of bone marrow and later in cancer patients receiving a relatively new type of immunotherapy called CAR T cell therapy.

CORONA VIRUS DEATH CAUSED BY EXTREME REACTION FROM IMMUNE SYSTEM

• Covid-19 can therefore release a cytokine storm in some patients as their immune systems fight the virus.
• These cytokines keep the body on high alert, even long after the viral load of the Covid-19 virus is no longer a threat. As the cytokines simply do their job, the “fight” results in a severe impact on multiple organs such as the lungs and liver, which can cause deadly complications.
• These cytokine storms can happen in people of all ages, but experts believe that this is the reason why so many young people died in earlier pandemics such as the 1918 influenza pandemic. In this pandemic as well, cytokines may offer clues into why younger people can be seriously affected by Covid-19.

CASE

• A city based private hospital has been given the nod by Indian Council of Medical Research to conduct clinical trials on COVID-19 patients using plasma therapy.
• Grant of permission given to conduct clinical study in India entitled “Open label, parallel arm, Phase I/II Clinical Trial to evaluate safety and efficacy of Convalescent plasma as therapy for COVID-19 Severe SARS-Cov-2 Disease
• Minister for Medical Education, Dr K Sudhakar,  who himself is a medical professional, wrote, “Plasma therapy holds great promise in treating Covid-19 patients and I am happy to inform ICMR agreed to our request and has given permission for plasma treatment to Dr. Vishal  Rao,  HCG Bangalore Inst of Oncology.”

COVID-19 IMMUNE SYSTEM BOOSTERS

• Zinc: meat, seafood, milk, whole grain, beans, seeds and nuts.
• Iron: lentils, spinach tofu, white beans.
• Vitamin A: Sweet potatoes, carrot, red bull, pepper, mango.
• Vitamin C: Broccoli, oranges, strawberries, tomatoes, guava, lychee.
• Vitamin E: Nuts, seeds, wheat grains, green leafy vegetables.
• Vitamin B: chickpeas, salmon.