An illustration of SARS-CoV-2, the strain of coronavirus that causes coronavirus disease 2019 (COVID-19)

Overview

Researchers and clinicians from across the Department of Immunology and Inflammation are working to understand the effects of COVID-19, the disease caused by the virus SARS-CoV-2, and mitigate its impact on patients and the general public. Our work is investigating the pathology of the disease through its effect on the body’s immune system and blood cells. Researchers are focusing on the roles and interactions between inflammatory cells, immune cells and the coagulation system, which are all activated either directly or indirectly by the virus. The key to combating the virus is to precisely modulate the immune response to boost its protective action and decrease immune-mediated damage to organs.

The work being undertaken within the Department will enable us to manage the current crisis and respond in a more agile way to inform the development of novel or repurposed therapeutics as well as recommend best clinical practice and policy.

Research

Blood clot

Haematology

Our research in Haematology is helping to understand the COVID-19 disease. Through understanding the immune response to COVID-19 infection, we can gain a detailed understanding of our body’s response to the virus. Our researchers are also working to understand the inflammatory and coagulation processes involved in disease progression which could not only allow clinicians to identify patients at risk of becoming severely ill, but also inform effective treatment options for patients.

  • Professor Kikkeri Naresh’s lab has proposed the use of cytotoxic T cells from convalescent COVID‐19 patients as the ‘need of the hour’ therapy to treat patients with COVID-19. Whilst there are many ongoing clinical trials utilising donor serum or plasma (a source of antibodies), not many are investigating T cell donation. Antibodies are only effective against extracellular viruses, but once a virus has entered the host cell it is shielded from the antibody. Cytotoxic T cells are an important element because they can fight viruses that have already infiltrated cells.
  • Professor Barbara Bain’s group have observed that lymphocytes with atypical morphology are seen in patients infected with SARS-CoV-2. They have indicated that this particular morphology may help in the clinical diagnosis of COVID-19. 
  • Professor Mike Laffan, as part of a team with Dr Quentin Hill at St James's University Hospital in Leeds, has provided practical guidance for managing patients with thrombocytopenia during the COVID-19 pandemic. Recommendations have been made available to support clinicians on the management and treatment of immune thrombocytopenia. 
  • In a new preprint, a team of researchers including Professor Frederick Tam have identified a drug which can be used in the management of COVID-19 patients with lung disease. Fostamatinib is already licensed as a tyrosine kinase inhibitor, but this work shows it may also be effective at reducing the presence of Mucin-1, a protein associated with poor clinical outcomes, on the lung surface.
  • Dr Deepa Arachchillage and colleagues at the Royal Brompton Hospital have found a link between COVID-19 and blood clotting. Despite being given the standard dose of anti-thrombotic medication, almost half of patients demonstrated thrombosis induced by COVID-19 infection. The team have described alternative drugs which can successfully anticoagulated these patients.

Image credit: David Gregory & Debbie Marshall

Acute kidney injury

Nephrology

The COVID-19 research activities in nephrology cover a wide range of topics to elucidate the link between renal disease and COVID-19, as well as developing preventative measures to improve clinical outcomes in patients with kidney disease. These patients are extremely vulnerable to COVID-19 so understanding the development of the disease in this patient population is crucial. Our research in this field addresses a public health knowledge gap and will inform policy regarding access to healthcare facilities, for vulnerable patients with chronic illness, during the pandemic.

Image credit: Amadalvarez

People discussing documents in a business setting

Policy and public engagement

Our laboratory-based research into the relationship between COVID-19 and its effect on the immune system, as well as our clinical work within the NHS, is informing both the local and national response to the pandemic. Members of our Department have also been working directly with policymakers and speaking in public-facing forums to offer vital insights into COVID-19 research. 

A clinical researcher wearing protective equipment and holding test tubes

Clinical trials

The multi-disciplinary collaborations formed by our scientists is changing our understanding of COVID-19 and of how patients with the disease in intensive care can be treated safely but quickly. In addition to vaccines, which are important for long-term control of the outbreak, drugs which manipulate the immune response may be vital to preventing progression of the disease in affected patients. Through researching the immune-related pathology of COVID-19, and the process of protective immunity against the virus, our Department is helping to identify new therapeutic drug targets and repurpose existing drugs.