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Natural killer (NK) cells are innate immune cells that contribute to host defense against virus infections. NK cells respond to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vitro and are activated in patients with acute coronavirus disease 2019 (COVID-19). However, by which mechanisms NK cells detect SARS-CoV-2-infected cells remains largely unknown. Here, we show that the Non-structural protein 13 of SARS-CoV-2 encodes for a peptide that is presented by human leukocyte antigen E (HLA-E). In contrast with self-peptides, the viral peptide prevents binding of HLA-E to the inhibitory receptor NKG2A, thereby rendering target cells susceptible to NK cell attack. In line with these observations, NKG2A-expressing NK cells are particularly activated in patients with COVID-19 and proficiently limit SARS-CoV-2 replication in infected lung epithelial cells in vitro. Thus, these data suggest that a viral peptide presented by HLA-E abrogates inhibition of NKG2A+ NK cells, resulting in missing self-recognition.

Background: Acute poisonings with prescription drugs is a growing problem. This study aims to describe the poisonings that come in to the Oslo accident and emergency outpatient clinic (OAEOC) with poisonings with prescription drugs; the most common combinations of drugs taken, the clinical features of the patients, and other characteristics of the patients such as gender and age. Method: Observational study. All patients presented at the OAEOC with acute poisonings between October 2013 to 2015 were included in the study, and variables were registered from the patients files. The variables included were toxic agents taken, age, gender, ethanol use, vital parameters, clinical features and method of arrival and discharge at the OAEOC including length of stay. Results: There were 2218 cases of poisonings over the 18 months in the study, and 36,9% of these were with one or more prescription drug. There were 23,3 % women in total and the median age was 37. The most commonly taken prescription drug was benzodiazepines (85%), followed by prescription opioids and methylphenidate. The vital parameters for the different groups are overall relatively similar, but it seems that the benzodiazepine and opioid users are in a worse clinical condition, mainly based on their low Glasgow Coma Scale scores and the high frequency of arriving by ambulance. There are also differences between the number of patients who have used alcohol in addition to drugs, and it seems like opioid users are less likely to drink alcohol. Conclusion: Use of benzodiazepines seems to be the largest problem when it comes to acute poisonings. Between the different groups of prescription drugs there were relatively small variations in vital parameters, but it seems that the users of benzodiazepines and prescription opioids were in a worse clinical condition than the rest of the patients.