Why is it important to have a healthy immune system?
The coronavirus infection, which is currently affecting the entire world, has highlighted the importance of having a healthy immune system. It is necessary in order to control the virus, to make the virus load disappear and to keep the symptoms mild; but also so that the immune response is not exaggerated.
We now know that many patients who die are due, in part, to the latter: to an exaggerated immune response to the virus. This is called immune hyperactivation or cytokine storm.
How does the virus currently affect our immune system?
Many studies conducted in China, Europe and the United States have analyzed the characteristics of the immune system of patients and now we know a little better the details of the defense system to see how we face this threat.
On the one hand, it is now clear that people who face the virus with low defenses can have a hard time. And this not only happens with people we call immunosuppressed, it can also happen with people who consider themselves immunocompetent, since some of them are not really immunocompetent. The two main characteristics associated with poor evolution of patients and which point to a lowering of defenses are lymphopenia and hypoalbuminemia.
On the other hand, a profile of blood alterations has been characterized that are associated with a poor evolution towards the dreaded cytokine storm. These include elevated levels of C-reactive protein, D-dimer, ferritin, neutrophils, LDH and a cytokine called interleukin 6.
As patients usually go to the hospital a few days after the onset of symptoms, we do not yet know exactly what the patient’s usual characteristics are, what he/she has before and when he/she becomes infected.
When we come out to the “new normal”, will we be vulnerable to common viruses after such a long period of confinement?
It is not foreseeable that a quarantine such as the one we have had in Spain will make people or patients more vulnerable when they restart their working life or when they go out into the street. The recommendation of social distancing, the use of masks and hand hygiene measures are the most important.
Confinement could affect parameters such as vitamin D, due to lack of exposure to sunlight in very susceptible people, so it is recommended that people who know they have a deficiency of this vitamin should have their levels checked. And it is an appropriate time when one might want to check one’s state of defenses in the face of an eventual coronavirus infection.
How can we deal with the virus for the future “new normal”?
From a preventive point of view it is good to know how the components of the immune system and other blood proteins are doing and to know if any of the components are altered, even when we are well.
Many asymptomatic people are lymphopenic and live healthy as long as they do not have a viral aggression that tests their personal defense capabilities. Knowing this, it can be useful to be warned so that if another wave comes, we can take better care of ourselves. If we know in advance how our immune system is doing, we can do something to improve defenses.
On the other hand, it is now known that people affected with the cytokine storm can receive therapies that prevent poor progression and the need to use a ventilator. If I already know I have a hyperactivation profile, it might be useful for me to be treated a little earlier without waiting until it is too late.
Although this is not mathematics, nor are there perfect ways to predict things in medicine, through a blood test we can know how things are going in my body in the face of this virus; in such a way that allows me to somehow anticipate prevention so as not to have a bad time.
If I have passed the virus, am I safe from a relapse?
If you have been infected, it is also important to know if you have developed defenses and to know how the parameters we have mentioned above have been once you have recovered from the symptoms.
As long as there is no vaccine, the recommendation is that we should not lower our guard; no one is guaranteed a good evolutionary course with this virus. Let’s take care of ourselves, let’s stay at home.