The immune system is complex and involves many genes, including those that encode cytokines known as interferons (IFNs). Individuals who lack specific IFNs can be more susceptible to infectious diseases. Additionally, the autoantibody system dampens IFNs response to prevent damage from pathogen-induced inflammation. Two recent studies now examine the likelihood that genetics affects the risk of severe coronavirus disease 2019 (COVID-19) through components of this system.

The study found enrichment of these genes in patients and conclude that genetics may determine the clinical course of the infection. A B cell autoimmune phenocopy of inborn errors of I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men. In these patients, adaptive autoimmunity impairs innate and intrinsic antiviral immunity. These findings provide a first explanation for the excess of men among patients with life-threatening COVID-19 and the increase in risk with age. They also provide a means of identifying individuals at risk of developing life-threatening COVID-19 and ensuring their enrollment in vaccine trials. Finally, they pave the way for prevention and treatment, including plasmapheresis, plasmablast depletion, and recombinant type I IFNs not targeted by the auto-Abs.

Lots of scientific lingo, I know, however, the fact that there may be a simple blood test that can identify those of us at highest risk for death from the coronavirus is promising! We are not out of the tunnel, we believe the light at the end is not an oncoming train but we can never be sure! Let’s keep reading what these amazing researchers are doing! Stay the course, stay strong, stay well, mask up, and stay tuned!