The test could inform doctors about the best treatment options.
For the first time, scientists have developed a score that can accurately predict which patients will develop a severe form of Covid-19.
The study, led by researchers from the RCSI University of Medicine and Health Sciences, is published in The lancet‘s translational research journal EBioMedicine.
The measurement, called the Dublin-Boston Score, is designed to enable clinicians to make more informed decisions as they identify patients who can benefit from therapies like steroids and ICU admission.
Up until this study, no Covid-19-specific prognostic values were available to guide clinical decision-making. The Dublin-Boston Score can now accurately predict how severe the infection will be on the seventh day after the patient’s blood was measured for the first four days.
Professor Gerry McElvaney (left), lead study author and advisor at Beaumont Hospital, and Professor Ger Curley (right) stand outside the RCSI Education and Research Center at Beaumont Hospital in Dublin. Photo credit: Ray Lohan
The blood test measures the levels of two molecules that send messages to the body’s immune system and control inflammation. One of these molecules, interleukin (IL) -6, is anti-inflammatory and another, called IL-10, is anti-inflammatory. The levels of both are changed in severe Covid-19 patients.
Based on the changes in the ratio of these two molecules over time, the researchers developed a scoring system in which every 1 point increase was associated with a 5.6-fold increased chance of a more serious outcome.
“The Dublin-Boston Score is easy to calculate and can be applied to any hospitalized Covid-19 patient,” said RCSI Professor of Medicine Gerry McElvaney, lead author of the study and advisor at Beaumont Hospital.
“A more informed forecast could help determine when to escalate or de-escalate supplies. This is a key component for the efficient allocation of resources during the current pandemic. The score can also play a role in assessing whether new therapies to reduce inflammation in Covid-19 are actually providing benefits. ”
The Dublin-Boston Score uses the ratio of IL-6 to IL-10 because it significantly outperforms the measure of change in IL-6 alone.
Despite high blood levels, the use of only IL-6 measurements as a Covid-19 forecasting tool is hampered by several factors. IL-6 levels within the same patient vary over the course of a given day, and the extent of the IL-6 response to infection varies between different patients.
Reference: “A linear prognostic score based on the ratio of interleukin-6 to interleukin-10 predicts the results COVID-19”Von Oliver J. McElvaney, Brian D. Hobbs, Dandi Qiao, Oisín F. McElvaney, Matthew Moll, Natalie L. McEvoy, Jennifer Clarke, Eoin O’Connor, Seán Walsh, Michael H. Cho, Gerard F. Curley und Noel G. McElvaney, 8. Oktober 2020, EBioMedicine.
DOI: 10.1016 / j.ebiom.2020.103026
The Dublin-Boston Score was developed by researchers from RCSI, Harvard University, Beaumont Hospital in Dublin, and Brigham and Women’s Hospital in Boston.
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