A binary model for the classification of chronic diseases has formerly been proposed. The model classifies chronic diseases as “high Treg” or “low Treg” diseases according to the extent of regulatory T cells (Treg) activity (frequency or function) observed. The present paper applies this model to severe acute respiratory syndrome coronavirus 2 (SARS – CoV – 2) infection. The model correctly predicts the efficacy or inefficacy of several immune-modulating drugs in the treatment of severe coronavirus disease 2019 (COVID-19) disease. It also correctly predicts the class of pathogens mostly associated with SARS-CoV-2 infection. The clinical implications are the following: (a) any search for new immune-modulating drugs for the treatment of COVID-19 should exclude candidates that do not induce “high Treg” immune reaction or those that do not spare CD8+ T cells; (b) immune-modulating drugs, which are effective against SARS-CoV-2, may not be effective against any variant of the virus that does not induce “low Treg” reaction; (c) any immune-modulating drug, which is effective in treating COVID-19, will also alleviate most coinfections; and (d) severe COVID-19 patients should avoid contact with carriers of “low Treg” pathogens.
【저자키워드】 COVID-19, SARS-CoV-2, Rapamycin, Co-infection, Treg, corticosteroids (CS), JAK inhibitor, statins, 【초록키워드】 Treatment, coronavirus disease, Coronavirus disease 2019, Efficacy, coronavirus, T cells, SARS-COV-2 infection, variant, Infection, drugs, CD8+ T cells, drug, classification, severe acute respiratory syndrome Coronavirus, virus, chronic disease, Regulatory T cell, pathogen, CoV, Pathogens, respiratory, disease, predict, regulatory T cells, Treg, Frequency, Contact, contact with, Chronic diseases, Candidates, acute respiratory syndrome, treatment of COVID-19, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, severe coronavirus disease, carriers, following, candidate, class, treating COVID-19, CD8+, carrier, immune reaction, clinical implications, effective, induce, alleviate, clinical implication, severe COVID-19 patient, 【제목키워드】 Model, binary, chronic,