Immune responses to COVID in patients with antibody deficiencies

Medical Exam

COVID infection in patients with antibody deficiency (COVAD) is part of a portfolio of national studies examining the immune responses in patients at high risk of COVID-19.

A new study, funded by UK Research and Innovation, aims to explore the immune response to natural COVID-19 infection and vaccination in patients with antibody deficiency. The study is being led by:

  • University of Birmingham
  • University Hospitals Birmingham NHS Foundation Trust
  • University College London.

Vulnerable patients

Immunodeficiency patients are considered vulnerable or extremely vulnerable to COVID-19 infection and have had to undertake preventative measures to minimise their risk of exposure to the virus.

Patients with antibody deficiency do not make good responses, if any, to most vaccines. However, it is not known whether they will respond to COVID-19 vaccines.

COVAD Chief Investigator Alex Richter, Professor of Clinical Immunology at the University of Birmingham, and Consultant Clinical Immunologist at University Hospitals Birmingham NHS Foundation Trust, said:

Nationally, a number of patients with immunodeficiency have had severe or prolonged illness with COVID-19. Understanding why some patients do well and others don’t is so important. Being unable to clear the virus is not just a problem to the patient but is potentially a public health problem too.

The researchers will be using Oxford Immunotec’s T-SPOT®.COVID test to test immunological responses. Samples will be taken from patients to measure the presence and level of antibodies in the blood and anti-SARS-CoV-2 T-cells.

Understanding virus transmission

The results of the research will be widely applicable to immunosuppressed patients and will help inform the development of vaccination strategies, as well as strengthen the understanding of risk for continuous virus transmission.

Co-principal Investigator Siobhan Burns, Professor of Translational Immunology at University College London, added:

This study is part of the national effort to understand how well vaccines work in vulnerable patients. We are also looking for persistent viral infections in our patients to understand whether this drives viral mutation.

Largest study of its kind

Professor Richter and Professor Burns are leading the COVAD research team at immunodeficiency centres at NHS hospital trusts across the UK. This will be the largest study of its kind, in this rare patient group world-wide.

The centres will screen patients and will invite those who are eligible and meet specific criteria to join the trial. If a patient is eligible for the study, their immunologist will be writing to them with more information.

Those who have been written to, who wish to take part in the study, should call the number provided on their invitation letter. Alternatively, they should inform the clinical team at their next immunology appointment that they would like to be considered for the COVAD study.

Professor Fiona Watt, Executive Chair of the Medical Research Council, part of UKRI, said:

This multi-partner study will explore a crucial area of COVID-19 research and tell us more about the immune response of immunodeficient individuals to natural COVID-19 infection and vaccination. The importance of this is two-fold: protecting some of the most vulnerable groups to severe effects of the disease, and understanding how the virus that causes COVID-19 may adapt within an individual who struggles to clear the virus.

Dr Andrew Makin, VP of Medical Affairs at Oxford Immunotec, stated:

We are pleased to be partnering with the University of Birmingham on this clinical trial which will help characterize COVID-19 infection in patients with antibody deficiency. Measuring the T cell response in immune deficient patients will allow for a more comprehensive understanding of the immune response and signify the vital role T cells play in SARS-CoV-2 infection.

Further information

The immunodeficiency centres are based at the following NHS Trusts:

  • University Hospitals Birmingham NHS Foundation Trust
  • Oxford University Hospitals NHS Foundation Trust
  • Salford Royal NHS Foundation Trust
  • North Bristol NHS Trust
  • London North West University Healthcare NHS Trust
  • University Hospital Southampton NHS Foundation Trust
  • Newcastle upon Tyne Hospitals NHS Foundation Trust
  • Barts Health NHS Trust
  • Cambridge University Hospitals NHS Foundation Trust
  • University Hospitals of North Midlands NHS Foundation Trust
  • University Hospitals Plymouth NHS Trust
  • Sandwell and West Birmingham NHS Trust

Top image: Credit: Geber86 / Getty Images

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