Abstract
COVID-19 is a disease caused by an infectious outbreak of the SARS-CoV-2 virus. Today, the virus is
widely spread throughout the world and declared by the World Health Organisation (WHO) as a
pandemic. There are a broad range of clinical presentations of a SARS-CoV-2 viral infection varying
from asymptomatic, sensation of a mild cold or flu to severe bilateral pneumonia and death. The
mortality is the highest in the elderly and in people with a pre-existing condition such as cancer.
In addition, it has already been shown that in patients with a severe COVID-19 infection the cytokine
levels in the blood are very high, which can lead to organ failure. Since in cancer patients cytokine
production is already increased by their disease and by treatment, this implies a higher susceptibility
to develop severe COVID-19 when an exaggerated immune response to this virus produces even more
cytokines ("cytokine storm"). The aim of this project is to be able to detect preventively when there is
a risk of developing a "cytokine storm" so that potential therapy such as cytokine inhibitors can be
used.
To accomplish this, the response of the immune system to SARS-Cov2 infection will be mapped in this
project. This will be done by performing immunological tests on blood samples from cancer patients
and a healthcare workers the same oncology units who seropositive for the SARS-CoV-2 infection. Both
blood samples from symptomatic and asymptomatic COVID-19 subjects will be examined
immunologically. The immunological tests include immunoassays, flow cytometry and
immunomethylomics.
The collection of blood samples has already started at the end of March 2020 and the inclusion period
is 3 months, so that the early phase, the peak phase and the foreseen decline of the pandemic are
included. Cancer patients are asked to take additional blood samples during routine blood samples. A
monthly blood sample is requested from the group of healthcare workers (4 samples per participant).
First of all, the seropositive samples will be detected on the basis of a serological test. These results
also provide insight into the proportion of infected high-risk patients in a hospital environment. On the
basis of the immunological tests, the immune response will be compared between the symptomatic
cancer patients and asymptomatic cancer patients and matched controlled healthcare workers. In this
way, immunological risk factors for the development of severe COVID-19 can be identified and a new
outbreak can be controlled in a scientifically responsible manner.
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