Defining the course of the COVID-19 disease in the immunosuppressed patient

COVID-19 is a severe, highly contagious condition that has forced the government to issue strict stay-at-home orders to reduce its spread. This advice is particularly important to protect vulnerable groups such as those with autoimmune conditions taking medications that suppress the immune system, who are more susceptible to infections. However, these people may have an advantage against the disease. Early evidence indicates that the overreaction of the immune system – the “cytokine storm”– is particularly damaging in COVID-19, which means that people receiving immunosuppressive therapies could in fact be protected.

A new research project, the DeCOmPRESS Study, (Defining the disease course and immune profile of COVID-19 in the immunosuppressed patient) will allow the team to better understand the disease and how it effects those who are medically compromised in our community.

Professor Mark Little, Clinical Medicine at the School of Medicine, was recently awarded government funding through the ‘Rapid Response Covid-19 Call’ for an important research project which will define the course of SARS-CoV-2 infection in patients with systemic autoimmune disease. Professor Little’s team will also determine if COVID-19 is severe in these immunosuppressed patients.

Using ANCA vasculitis (an autoimmune disease affecting small blood vessels in the body) as a model autoimmune disease, the team will characterise the immune response in COVID-19 in these patients. Through the Rare Kidney Disease Biobank, we have access to an engaged and well-connected network of patients, eager to help us understand more about the disease. Vasculitis patients who test positive for COVID-19 will provide blood samples and clinical information to allow us to measure the types of immune cells that are impacted during SARS-CoV-2 infection.

This will allow the team to better understand how the immune system responds to the virus and assess whether immunosuppressive therapies could be used to treat COVID-19. It will also assist in providing clear guidance to patients with respect to cocooning and current use of immunosuppressant medication.

Speaking on the importance of this research project, Professor Mark Little said:

 The DECOMPRESS project will determine the outcome of patients taking immunosuppressive medication who contract SARS-Cov2. This will allow us to target accurate advice regarding cocooning to these patients, and to inform development of new therapies and biomarkers. Conventionally, we assume that, when the immune system is suppressed, the ability to fight infection is impaired. While this is certainly true generally, these medications may actually protect against the “cytokine storm” that characterises severe COVID-19. The project will build on work in the Irish Rare Kidney Disease registry and biobank, and will incorporate six clinical research facilities around Ireland, a dedicated smartphone app developed by patientMpower, the immunology expertise of St James’s Hospital and the data integration capability of the ADAPT SFI centre.

The study will rapidly deliver critical information on how patients with autoimmune and chronic inflammatory diseases should be managed during this pandemic.

The team will deliver its first report within three months (from April 2020).