Inflammation
The Guardian article “Coronavirus: what happens to people's lungs when they get Covid-19?”
reports that “almost all serious consequences of COVID-19 feature pneumonia”. This is caused by the body’s response: inflammation. This can lead to an “outpouring of inflammatory material [fluid and inflammatory cells] into the lungs” and “reducing the body’s ability to take on oxygen and get rid of carbon dioxide.”
It concludes that our risk of getting pneumonia increases with age because of our weakening immune system.
However, it is believed that adult immune systems can “overreact”. This is in the same way that an unvaccinated adult’s immune system being more mature, reacts more strongly to the chicken pox virus than a child’s whose immune system is less developed. Unlike children, who clear the virus up on their own, adults who develop chicken pox often end up in hospital.
“For any infectious disease, part of the symptoms and damage are caused by the germ itself, while part is caused by our immune system responding to the infection,” according to a National Geographic article.
The added burden of a cascading inflammatory response to COVID-19 complicates recovery in those with co-morbidities like high blood pressure, cardiovascular disease, diabetes, cancer and those with chronic respiratory illnesses such as cystic fibrosis and asthma.
Further, a prolonged, complicated recovery, also ties up hospital beds for longer than necessary according to a German study published on 10 March 2020: “Novel Resolution Mediators of Severe Systemic Inflammation”:
“Nonresolving inflammation, a hallmark of underlying severe inflammatory processes such as sepsis, acute respiratory distress syndrome and multiple organ failure is a major cause of admission to the intensive care unit and high mortality rates. Many survivors develop new functional limitations and health problems, and in cases of sepsis, approximately 40% of patients are rehospitalized within three months.”
A challenge in this area is “the lack of knowledge underlying the complex pathophysiology of the inflammatory response organized by numerous mediators and the induction of complex networks impede curative therapy” according to the German study. It suggests that with COVID-19 there is more we can/should do, not least of which is to explore innovative solutions.
This said, the French Health Minister cautioned that traditional “anti-inflammatory drugs are known to be a risk for those with infectious illnesses because they tend to diminish the response of the body’s immune system”, according to The Guardian on 15 March 2020.
A US paper published 12 March 2020 titled “How doctors can potentially significantly reduce the number of deaths from Covid-19” confirms studies emerging from China suggesting it is the patients own out-of-control immune system, rather than the virus that is proving lethal. This is called a cytokine storm, and it could involve a genetic vulnerability, and/or conflicting treatments.
Research in other domains that have had to deal with cytokine storms, could be helpful. That is why China is using Rheumatoid Arthritis drugs such as ones from Roche, Sanofi and Regeneron.
However, researchers at Royal Adelaide Hospital have found that fish oil can help reduce the symptoms of Rheumatoid Arthritis which is an autoimmune disease where the body’s immune system attacks the lining of joints. They now treat patients with a dose of anti-inflammatory fish oil. Advantages include inflammation is resolved without depressing the immune system, fewer side effects, cost and wide availability.