Pre-existing T-cells stop COVID-19 before it starts and explains why some never get COVID

Have you met someone who never got COVID-19 even if exposed to many sick people?

An emergency room physician told me about an x-ray technician who did not get COVID-19 during the pandemic. The tech will go about her usual routine of getting the COVID-19 patients from their rooms, bringing them over for the procedure, and returning them. Without wearing a mask. Why didn’t she get sick?

I know a lady storekeeper who has been exposed to many people with COVID-19 but never got sick. How can that be?

A study from the University College of London answered that question. The researchers looked into why some health care workers (HCW) exposed to COVID-19 never got sick. The study is on Nature.com.

First, they tested the healthcare workers (HCW) to know if they had exposure to the SARS-CoV-2 virus. They measured a substance in their blood called interferon-inducible transcript (IFI27). IFI27 is a sign of a SARS-CoV-2 infection that was stopped by the immune system in the initial stages.

They also tested the serum of those HCWs for antibodies against the SARS-CoV-2, and they found none. The absence of anti-SARS-CoV-2 antibodies means they did not have an infection. Henceforth we will call them seronegative healthcare workers or SN-HCW.

During the study, the SN-HCWs were tested several times for the COVID-19 (16 total), and they continued to stay negative.

So what is in those SN-HCWs that allowed them to stop a COVID-19 infection at an early phase without having antibodies?

T-Cells against RNA Polymerase

Background: SARS-CoV-2 viruses have to multiply to start an infection. They have a built-in enzyme called RNA polymerase that transcribes DNA to RNA. After that, RNA is translated to make viral proteins.

It turns out. The SN-HCWs have T-cells that specifically attack the RNA polymerase of the SARS-CoV-2. If there is no RNA polymerase, that means no SARS-CoV-2 replication will happen. Which means no COVID-19 infection. And since they did not have an infection, the immune system did not make anti-SARS-CoV-2 antibodies.

Here is the exciting part. The SARS-CoV-2 RNA polymerase is genetically conserved. That means it is similar to the RNA polymerase of other human coronaviruses that are common and have been around for years. Coronaviruses are responsible for 20-30% of viral infections every year.

What happened to the SN-HCWs is that the T-cells against the RNA polymerase developed as an immune response from previous repetitive exposures to low doses of coronaviruses. Those T-cells made stayed in the body and continued to be effective against the SARS-CoV-2.

T-cells are in everybody’s blood. The group of SN-HCW is the same as the other health care workers who had COVID-19 in terms of age, sex, and ethnic background.

This phenomenon about T-cells has happened before.

Many have reported that some people do not get hepatitis B, hepatitis C, Japanese B encephalitis, and HIV even if they were exposed to those viruses multiple times. All of those are due to the T-cells.

Take-away message

Repeated low dose exposures to coronaviruses lead to the development of T-cells specific to the RNA polymerase. Those T-cells stop COVID-19 and last for a long time.

Do you think masking, lockdowns, and forced quarantines will do that?

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Reference:

Swadling, L., Diniz, M.O., Schmidt, N.M. et al. Pre-existing polymerase-specific T cells expand in abortive seronegative SARS-CoV-2. Nature (2021). https://doi.org/10.1038/s41586-021-04186-8

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