Emory University researchers reveal that nasal swab tests can predict the severity of COVID-19, offering critical insights for more personalized treatment plans. The groundbreaking study suggests that autoantibodies in the nasal cavity play a protective role, which could revolutionize how respiratory infections are understood and managed.
In a groundbreaking discovery, researchers at Emory University have identified a precise method to predict the severity of COVID-19 by analyzing autoantibodies in nasal swabs. This significant finding could lead to more personalized treatment plans, especially for high-risk individuals.
The study, published in Science Translational Medicine, observed 125 patients with various levels of COVID-19 severity over nearly two years. The researchers analyzed antibodies in both the blood and nasal airways, finding that more than 70% of those with mild or moderate COVID-19 developed certain autoantibodies in the nose. These autoantibodies were surprisingly linked to fewer symptoms, better antiviral immunity and faster recovery.
“Generally, autoantibodies are associated with pathology and a negative prognosis, causing increased inflammation that would indicate more severe disease,” senior author Eliver Ghosn, an assistant professor at Emory University School of Medicine/Lowance Center for Human Immunology and a researcher at Emory Vaccine Center, said in a news release. “What’s interesting about our findings is that with COVID-19, it’s the opposite. The nasal autoantibodies showed up soon after infection, targeting an important inflammatory molecule produced by the patient’s cells. These autoantibodies latched on to the molecule, likely to prevent excessive inflammation, and faded as people recovered, suggesting the body uses them to keep things in balance.”
This study contrasts with previous research that often focused on autoantibodies in the blood, which are typically associated with a grim prognosis.
“The key to this puzzle was to look directly at the site of infection, in the nose, instead of the blood,” Ghosn added.
The research also introduced a promising diagnostic tool called FlowBEAT, developed by the Ghosn lab. FlowBEAT enables precise measurements of antibodies in nasal cavities and other biological samples, enhancing the efficiency and accuracy of diagnosing respiratory infections. This new tool has implications beyond COVID-19, potentially aiding in the detection of other respiratory viruses like flu and RSV.
“Historically, the technology to measure antibodies has low sensitivity and is inefficient since they are limited to measuring one or a few antibodies at a time,” added Ghosn. “With FlowBEAT, we can take any standard nasal swab and perform a combination test to simultaneously measure all human antibody types against dozens of viral and host antigens in a single tube – a much more sensitive, efficient and scalable way to measure for autoantibodies in the nose that can also predict the severity of symptoms.”
Looking ahead, the researchers aim to explore whether the nasal autoantibody response is a common protective mechanism across other respiratory infections.
“If this nasal autoantibody response turns out to be a common mechanism to protect us against other viral infections, it can be a paradigm shift in how we study protective immunity,” Ghosn added. “We will interpret autoantibodies through an innovative lens, hopefully inspiring new lines of research and better therapeutic options for common respiratory infections.”
Ben Babcock, a doctoral candidate who led the study, emphasized the potential for real-time diagnostic advancements.
“Imagine if we could capture the immune response in real-time, right in the clinic. A just-in-time test could give physicians and patients the real-time information they need to make faster, smarter treatment decisions,” he said in the news release.
The results could set the stage for predictive diagnostic tools developed from standard nasal swabs, revolutionizing how respiratory viruses are detected and treated.