It’s reassuring to know that some of Cambridge’s brightest medical minds have been focussed on the challenge of COVID-19 and the SARS-CoV-2 virus since early this year. When the Evelyn Trust put out a call for research projects that could help boost the international research effort, trustees were particularly excited by the potential of the work of Professor Ken Smith and his group based at the Cambridge Institute of Therapeutic Immunology and Infectious Disease. Professor Smith is an expert in immune regulation and his project is an immune phenotyping programme, working with the developing National Institute of Health Research COVID Bioresource. Immune phenotyping is the examination at a cellular and biochemical level of the immune systems of individuals. The COVID Bioresource is unique as it comprises samples from individuals across the full spectrum of immune reactions: asymptomatic; mildly symptomatic; those suffering from very serious illness; and tragically some who have lost their lives to COVID-19.

Professor John Bradley, who is closely involved in the research, explains how the COVID-19 Bioresource has been built this year. “Addenbrooke’s Hospital was one of the first hospitals to routinely screen healthcare workers for COVID-19. These samples from staff, combined with those from some seriously ill patients, have given us an incredibly useful insight into individual immune system reactions to the virus. We have been able to take repeated blood samples at regular intervals to track patients and staff over many months, working to understand the way the infection can progress and the immune response it provokes at an individual level. Ken and his team have been looking at key cellular changes in the immune response and have collected data on over 40 cell types in the last few months.”

Early results from the research have demonstrated very profound changes to the immune system during COVID-19 infection, including a dramatic reduction in a number of important immune cell types. These changes are worse in patients with more serious symptoms and analysis of samples from patients with improving health show that even 28 days later these levels generally fail to recover. This leaves patients potentially vulnerable to other infections. The team is also hoping soon to announce important findings about how oxygen levels – which can be profoundly reduced in COVID – may influence the immune response. This could provide the evidence for a new approach to oxygen therapy that has strong potential to improve patient outcomes.

“The Evelyn Trust grant has been invaluable to our project and has helped us to secure significant funding from Addenbrooke’s Charitable Trust, UK Research and Innovation and the Medical Research Council. This will fund longer term follow up of patients who have suffered COVID-19, and in particular study the neurological and mental health consequences. Our plan is to extend this project to track individuals over perhaps a couple of years. This will help us to understand impacts on the immune system over time and so enable us ultimately to improve treatment for patients with the serious ‘long-COVID’ that is now being reported,” John comments. 
 
You can find out more about the ground-breaking work of the Cambridge Institute of Therapeutic Immunology and Infectious Disease at www.citiid.cam.ac.uk