Quantitative and qualitative pathological changes in the immune system of patients infected with SARS-CoV-2

In December 2019, the ongoing outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic broke out in Wuhan china and rapidly spread around the globe. As a new type of a highly contagious disease in humans, current understanding of the disease is incomplete, and information is revealed daily. Coronavirus is an RNA virus consisting of positive-sense single-stranded RNA of approximately 27-32 kb. It belongs to the family Coronaviridae, which comprises of alpha, beta, delta, and gamma coronaviruses. The disease is characterised by asymptomatic disease in about 85% of affected individuals and a severe pneumonia which requires ventilation in 15% of the affected. An additional 5% of those affected proceed to much more severe disease necessitating supplemental oxygen due to hypoxemic respiratory failure combined with multiorgan failure. Research work will be done to interrogate changes that occur on the immune system by looking at all cellular subsets involved in the immune response, cytokine production and immunoglobulin production in response to infection with SARS-COV-2. The main goal is to investigate the cellular and cytokine changes that characterize the immune response to SARS-COV-2 infection in the following subgroups: patients with asymptomatic, mild/ moderate and severe symptomatic infection; and people who have been directly exposed (to patients with infection) but remain uninfected and/or asymptomatic. Using this information, new biomarkers and novel targets for immunomodulation can be identified which can facilitate prognosis and disease management since currently no effective treatment exists. The analysis of biomarkers and immune responses will help us to understand the dynamics of SARS CoV 2 infection in asymptomatic patients, symptomatic patients and close contacts (who test negative) of patients with Covid-19. Expected Outputs  Research papers to be published which will aid in the understanding of immune system reaction to CoVID-19 a paper will be published in a high impact factor journal, this will be accompanied by participation in conferences to further disseminated the information learned.  The variant analysis which will be performed will aid in the identification of strains circulating in Botswana, their virulence and transmissibility and importantly the efficacy of available vaccines on these strains. This information will be shared with key policymakers to enable then to plan accordingly