Study Reveals Why Chronic Lung Disease Raises Severe COVID-19 Risk

A new study has uncovered why patients with chronic lung disease face a higher risk of severe COVID-19. Researchers found that molecular changes in lung and airway cells make these patients more vulnerable to SARS-CoV-2 infection. The findings, published in Nature Communications, highlight how altered immune responses and cell behaviour contribute to worse outcomes.

An international team, co-led by the Translational Genomics Research Institute (TGen), analysed lung and airway cells from chronic lung disease patients. Using single-cell RNA sequencing, they identified key molecular differences that may explain increased susceptibility to COVID-19. Cells from these patients showed higher 'viral entry scores', meaning the virus can enter and replicate more easily.

The study also revealed significant changes in immune cells, particularly T cells, which weaken the body’s defence against the virus. These alterations reduce the patient’s ability to fight infection, raising the risk of severe illness. Dr. Nicholas Banovich, a senior author and associate professor at TGen, and Dr. Jonathan Kropski of Vanderbilt University Medical Center led the research alongside other institutions, including Yale School of Medicine and several UK-based partners. Linh Bui, Ph.D., a post-doctoral fellow in Dr. Banovich’s lab, served as one of the lead authors. Funding for the study came from major organisations, including the National Institutes of Health, the Department of Defense, the Department of Veterans Affairs, and the Doris Duke Charitable Foundation.

The research provides a clearer picture of why chronic lung disease worsens COVID-19 outcomes. By pinpointing molecular and immune system changes, the findings could help develop better treatments for high-risk patients. The study’s insights may also guide future research into targeted therapies for those with pre-existing lung conditions.