2021-08-31

New research finds possible drivers of death from COVID-19, which overturns previous theories

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New research finds possible drivers of death from COVID-19, which overturns previous theories

A new study led by researchers from New York University’s Grossman School of Medicine shows that people who have died of COVID-19 are in their lower respiratory tract The amount of virus (or known as the viral load) is, on average, 10 times that of those who have survived severely ill patients. At the same time, investigators did not find any evidence that secondary bacterial infection was the cause of death, although they reminded that this may be caused by the frequent use of antibiotics for critically ill patients.

“Our research results show that the body cannot cope with the large number of viruses infecting the lungs, which is largely the cause of death from the COVID-19 pandemic,” the lead author of the study, New York University Lang Said Dr. Sulaiman, associate professor of medicine at the Gurney School of Health.

He pointed out that the current guidelines of the US Centers for Disease Control and Prevention discourage the use of antiviral drugs such as remdesivir for critically ill patients with mechanical ventilation. But Sulaiman said that the results of studies at New York University Langone indicate that these drugs may still be valuable tools for treating these patients.

Although some people have previously worried that this virus may cause the immune system to attack the body’s own lung tissue and cause dangerous levels of inflammation, investigators found no evidence that this was a COVID-19 death in the research group The main reason. In fact, Sulaiman pointed out that the strength of the immune response seems to be proportional to the amount of virus in the lungs.

Researchers say that so far, the coronavirus has caused more than 4 million deaths worldwide. Those who are placed on mechanical ventilators to breathe are in a particularly bad situation. 70% of people in the United States die from this disease. It is worth noting that experts attribute the high mortality rates seen in other viral pandemics to secondary bacterial infections, such as the Spanish flu in 1918 and the swine flu in 2009. However, it is still unclear whether patients with COVID-19 are plagued by similar problems.

According to Sulaiman, this new study published online today (August 31, 2021) in the journal Nature Microbiology aims to clarify secondary infections, viral load, and immune cell populations Role in COVID-19 mortality. He said this survey provides the most detailed survey of the lower respiratory tract environment of coronavirus patients.

In the investigation, researchers collected bacterial and fungal samples from the lungs of 589 men and women hospitalized at NYU Langone Hospital in Manhattan and Long Island, all of whom require mechanical ventilation. For 142 patients who also underwent bronchoscopy to clear their air passages, the researchers analyzed the amount of virus in their lower respiratory tract and determined the presence of microorganisms by studying the small genetic code of the bacteria. The study authors also investigated the location of the Types of immune cells and compounds in the respiratory tract.

Research shows that compared with those who survived the disease, the production of an immunochemical against the coronavirus is 50% lower in those who died. These customized proteins are part of the body’s adaptive immune system, which is a subset of cells and chemicals that “remember” newly encountered microorganisms that invade, so that the body is better prepared for future exposure.

“These results indicate that a problem with the adaptive immune system is preventing it from effectively fighting the coronavirus,” said Dr. Leopoldo Segal, senior author of the study. “If we can determine the source of this problem, we may be able to find an effective treatment that works by enhancing the body’s own defense capabilities.”

He reminded that investigators only studied Coronavirus patients who survived the first two weeks of hospitalization. He said that bacterial infections or autoimmune reactions may play a greater role in the earlier COVID-19 mortality rate.

Segal said the research team next plans to observe how the microbial community and immune response in the lungs of coronavirus patients change over time.