Using T-cells to understand the risk of getting very sick from covid

The immune system is crucial for protecting against covid. Our bodies produce a type of white blood cell, called T-cells that can recognise and kill infected cells to stop a virus spreading. When you receive a covid vaccine, it trains our bodies T-cells to recognise the virus so that if you encounter the virus in the real world, our T-cells can respond quickly and effectively to destroy the virus. Some people with blood cancer have fewer T-cells or have T-cells that don’t work properly. This means they have a higher risk of becoming unwell from covid even if they have had several doses of the covid vaccine. Current tests mean we can’t easily check how well someone’s T-cells are working. If researchers could measure T-cell activity they might be able to understand whether someone is at risk of getting very sick from covid.

This project builds on an ongoing clinical trial called STRAVINSKY, which is funded by the National Institute for Health Research (NIHR). STRAVINSKY stands for ‘Stratification of Clinically Vulnerable People for COVID-19 Risk Using Antibody Testing’. The project has recruited 3,000 vulnerable people in the UK, including around 800 people with blood cancer, to study how their immune systems respond to covid vaccines. The main goal is to see if measuring immune cells can help estimate a person’s risk of getting very sick from covid. In this new project, Dr Sean Lim and her team plan to use the samples from the STRAVINSKY trial to compare two new tests which measure T-cell activity to see how well they work and if they can predict the risk of severe covid in people with blood cancer. They also hope to decide whether one of these tests could be rolled out and used in the NHS.

If the team find a T-cell test that can accurately predict the risk of someone getting very sick from covid, the goal is to make it available across the NHS. This would allow for routine testing to identify those at higher risk of severe covid, helping doctors decide who might need extra treatments or other protective measures after vaccination.