COVID Mystery: Why are some patients asymptomatic while others need to be hospitalized? We've known for a year that #COVID19 patients who have trouble breathing often have too much inflammation in the lungs (alveolitis). Now we know what's happening on a microscopic level: 1/
Within the lungs, an inflammatory cell called a macrophage becomes infected with #coronavirus, prompting the cell to release signals that attract T cells. These activated T cells then stimulate macrophages, forming a feedback loop that drives inflammation. nature.com/articles/s4158…
This is a crucial insight with important implications for treatment. It suggests we might help the sickest #COVID patients by disrupting the inflammatory feedback loop with drugs that inhibit macrophages or activated T cells. There's an NIH-sponsored study trying to do just that.
Very sick #COVID patients across the U.S. are enrolling in ACTIV-1 so they can receive an experimental drug called cenicriviroc (which targets macrophages) or abatacept (targets T cells). This trial hopes to break the feedback loop. Later this year, we'll find out if it works.
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