A Covid disease can trigger acute shortness of breath – even before the virus can damage the lungs. German researchers have now been able to identify the reason for this early lack of oxygen.
At the end of 2019, the coronavirus was reported for the first time as the trigger of a new type of lung disease. If the viral disease is severe, it can lead to acute respiratory distress syndrome in those affected.
As part of an international study, Lukas Flatz and Tobias Sonnberg from the Department of Dermato-Oncology at the University Skin Clinic in Tübingen researched the causes of this early lack of oxygen.
To do this, the researchers took a closer look at blood samples as well as lung tissue and fluid from seriously ill Covid 19 patients from hospitals in Switzerland and Germany. A severe Covid-19 disease was present when oxygen had to be supplied due to Sars-CoV-2. Results of previous research have already shown that the lungs of Covid-19 patients are similar to those who were not infected with Sars-CoV-2 but still have acute lung failure or have partially or completely collapsed. Breathing problems became apparent before the organ damage caused by the coronavirus reached the lungs. The Tübingen scientists were the first group of researchers to identify the cause of the corona-related lung failure.
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In the case of a Covid-19 infection, autoantibodies form, which in turn form endogenous antigens. “We were able to show that patients with a severe course of Covid-19 produce a rapid and sustained production of the antibody immunoglobulin A (IgA) during the early immune response to the infection,” explains Sinnberg, first author of the study.
The result is increased IgA levels. IgA are proteins that are part of the body’s immune system and are found in both blood and mucosal secretions. On the mucous membranes, they form a protection against pathogens such as the corona virus by neutralizing them and preventing them from penetrating further into the body. The IgA antibodies bind to proteins in the mucous membrane secretion, surfactant, which the lung cells in the alveoli (air sacs) produce. These proteins are necessary for oxygen exchange in the lungs. Together with the surfactant, they are essential for the stability of the alveoli. “The study results show that in the case of an infection with the coronavirus, the increased levels of the IgA antibody lead to a deficiency in this mucous membrane secretion,” says Flatz. “As a result, the lungs collapse, resulting in shortness of breath.” Affected patients therefore need support when breathing through additional oxygen supplied.
