COVID-19 immunology review: What we know and priorities for research

A new expert summary, which rapidly reviewed COVID-19 immunology research and identified urgent research priorities, has been published today (Friday 1 May).

The paper reviews what we know about COVID-19 from immunology research and highlights knowledge gaps that could hamper efforts to get the pandemic under control. You can also find an accessible Q&A to accompany the report on our website. 

The Academy of Medical Sciences and the British Society for Immunology established an expert advisory group in early April 2020. Together the experts reviewed the limited research that is currently available and identified key research priorities.

Professor Arne Akbar FMedSci, Chair of the advisory group and President of the British Society for Immunology, said:

“Immunology is at the heart of some of the most pressing issues in this pandemic, such as the best way to develop vaccines and treatments, how long people with the virus remain infectious, and when or if these people become immune.

“We brought together 15 leading immunology experts to rapidly review what we now know about COVID-19 and what we most urgently need to find out.”

The review aims to help researchers, funders and policymakers navigate existing research findings and focus future research on areas that will make the biggest difference to patients and society. The project has also been condensed into a question and answer blog, which is more accessible for those without a research background.

The project highlighted four research questions with high public health impact that could be answered quickly about immunity and four questions about treatment:

Rapid learning about immunity for public health impact

  1. What, if any, antibody properties confer protection against the virus, and what proportion of antibody responses are protective?
  2. What are the roles of immune cells from the adaptive (T-cells) and innate systems, such as Natural Killer cells and T-cells, in protective immunity?
  3. What is the sero-prevalence of SARS-Cov-2 antibodies? What proportion of individuals mount either an antibody, or a cellular response or both after infection?
  4. How can laboratory-based antibody tests be safely scaled to reliable commercial equivalents that are not confounded by cross-reactivity to other coronaviruses?

Rapid impacts for COVID-19 treatment

  1. What is the full immunopathology of COVID-19 in the lung and other organs?
  2. What are the biomarkers predictive of severe disease?
  3. What is the potential role for antiviral and immunomodulation therapies in COVID-19 treatment?
  4. How can we reliably test whether COVID-19 patients remain infectious?

Professor Janet Lord FMedSci, Director of MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, said:

“Research has already told us a lot about the way our immune system responds to COVID-19, but there is an awful lot we don’t know yet. This knowledge gap is hampering our efforts to stop the pandemic.

“To make a real difference we are going to have to work quickly, collaboratively and smartly. We will need to rapidly assemble teams of researchers working in different disciplines, different institutions and across sectors. We will need to work with partners in industry, with the public, with regulators and policy makers.

“The challenges facing us may be great, but this review gives us a clear roadmap to help focus our efforts.”

This project was a collaboration between the Academy of Medical Sciences and the British Society for Immunology, Academy of Medical Sciences staff time and Academy costs for this work were supported by a core grant received annually from the Government Department for Business, Energy & Industrial Strategy (BEIS).

To find out more about other Academy activities on coronavirus, please visit our Coronavirus information hub. To find out more about our policy work please visit our dedicated web pages. Please visit our support us page to find out more about supporting the work of the Academy. 

-ENDS-

More information on this work can be found on the dedicated policy project page.

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