Spectrum, MSU find COVID-19 patients fall into two groups

Cellular research shows not all patients should receive the same treatment.
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A new study could lead to greater understanding of COVID-19 treatment after underscoring the importance of precision medicine and personalized care.

Spectrum Health and Michigan State University College of Human Medicine have determined through a research study that patients infected with COVID-19 fall into two distinct groups: those who exhibit a highly overreactive immune system, and those who exhibit immune suppression.

According to the findings, which were published in Frontiers of Immunology, the first group could benefit from immunosuppressive drugs while the second group could benefit from immune-stimulating therapies.

Dr. Surender Rajasekaran. Courtesy Helen DeVos Children’s Hospital

Among the researchers involved was Dr. Surender Rajasekaran, research medical director and pediatric intensivist at Helen DeVos Children’s Hospital. Rajasekaran said the goal of the study was to determine if a patient’s RNA could be used to increase understanding of COVID-19 and lead to more personalized treatment.

“A greater understanding of severe COVID-19 could help identify which patients are at risk for complications, which would guide more precise therapy,” Rajasekaran said. “As the virus itself continues to evolve and change, there is immense benefit to understanding the patient’s response to infection.”

COVID-19, or SARS-CoV-2, is an RNA virus that elicits an overactive immune response, causing damage to cells. Since the outbreak of the COVID-19 pandemic, patients have experienced different reactions to infection, ranging from hospitalization and a need for ventilation to mild symptoms or even asymptomatic cases.

The study was conducted on a group of 51 adults, 36 of whom were hospitalized with COVID-19 at Spectrum Health and 15 of whom served as controls. Researchers received written consent to draw blood samples from the patients and used those samples to examine each patient’s RNA within the blood through high-density sequencing.

Samples were collected at different time points — one early on and then one in 23 of the patients after treatment with different therapies. The results indicated variability in patients when it came to what treatment options worked best, depending on reaction to the treatments.

Jeremy Prokop. Courtesy Michigan State University College of Human Medicine

Jeremy Prokop, Ph.D., assistant professor at Michigan State University College of Human Medicine, said the team “wanted to do things differently than everybody else” when it came to COVID-19 research.

“We went all-in on these few samples to try to gain as much information as we could,” Prokop said. “We ended up doing a study that essentially gave us more information and sequencing at a deeper level than what had been done before.”

Prior to this study, Rajasekaran and Prokop collaborated on some pediatric illness research. They started to look at cell function in greater detail, which sparked their interest in how viruses invade cells and led to this COVID-19 research.

Now, they see these findings as a better opportunity for precision medicine and understanding complexities — not just among COVID-19 patients but those with other infections as well.

“Just like COVID-19, most infections result in a complex immune response for each patient, with no two individuals having the same biological outcomes,” Prokop said. “Through forming strong collaborations between industry, academia and hospitals we continue to get one step closer to treating each patient based on how the infection changes their body.”

Rajasekaran said he is hopeful the research also will help with long-term effects of COVID-19 and other infections.

“Not only is this beneficial in battling the current COVID-19 health crisis, but it would also be invaluable in treating future infectious diseases,” Rajasekaran said. “Long-term, this data may help clinicians and researchers predict, prevent and treat long-term complications of COVID-19 and any other viral infections.”

The team for this study consisted of researchers from Spectrum Health, Michigan State University, Helen DeVos Children’s Hospital, Ambry Genetics, Grand Rapids Community College, Calvin University, Grand Valley State University, Davenport University and Children’s Hospital of Pittsburgh.

Funding for this research was provided by donors from the Spectrum Health Foundation Gala 2020, the Spectrum Health-Michigan State University Alliance, Michigan State University and the National Institutes of Health.

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