As the COVID-19 cases continue to shoot up across the globe, scientists are still trying to understand the disease’s behavior to stop it and prevent future outbreaks.
According to the report, as of mid-August 2020, more than 22M laboratory-confirmed cases have been documented worldwide, with over 770K deaths. To date, numerous possible treatments for COVID-19 have been thrust into the spotlight by public health officials.
Although it’s public knowledge that the virus develops severe symptoms mostly in patients with comorbidities, weak immune systems, or other underlying conditions, there have been numerous exceptions across the globe. It has been seen that even healthy patients with absolutely no underlying conditions, have developed severe symptoms or even died due to the COVID-19.
Scoring system for COVID-19 testing
Recently, scientists have developed a scoring system for the first time that can accurately predict which hospitalised patients will develop a severe form of COVID-19.
The blood test was developed by researchers at RCSI University of Medicine and Health Sciences in Dublin and the US. It is published in The Lancet’s translational research journal EBioMedicine.
Called as the Dublin-Boston score, the measurement enables clinicians to make more informed decisions when identifying patients who may benefit from therapies, such as steroids, and admission to intensive care units. Previously, clinicians didn’t have any sort of COVID-19-specific prognostic scores to refer to for decision making.
But now, the blood test measurement can accurately predict how severe the infection will be on Day-7 after measuring the patient’s blood for the first four days. The 4-day change in IL-6:IL-10 ratio was chosen to derive the Dublin-Boston score.
How does it work?
According to the researchers, the blood test works by measuring 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 pro-inflammatory, and a different one, called IL-10, is anti-inflammatory. The levels of both are altered in severe COVID-19 patients.
Depending on the changes in the ratio of these two molecules over time, researchers have developed a scoring system where each 1-point increase was associated with 5.6 times increased odds for a more severe outcome.
“The Dublin-Boston score is easily calculated and can be applied to all hospitalised Covid-19 patients,” says RCSI Professor of Medicine Gerry McElvaney, the study’s senior author and a consultant in Beaumont Hospital.
The Dublin-Boston score uses the ratio of IL-6 to IL-10 because it significantly outperformed measuring the change in IL-6 alone. Despite high levels in the blood, using only IL-6 measurements as a COVID-19 prognostic tool is hindered by several factors. IL-6 levels within the same patient vary over any given day, and the magnitude of the IL-6 response to infection varies between different patients.
Talking about the limitations, researchers say, “This study has inherent limitations. While the number of patients is more than three-fold larger than prior similar studies in medically ill patients, the sample size is still small, and lacks a replication cohort.”
“More informed prognosis could help determine when to escalate or de-escalate care, a key component of the efficient allocation of resources during the current pandemic. The score may also have a role in evaluating whether new therapies designed to decrease inflammation in COVID-19 provide benefit,” he adds.
The research was funded by the Elaine Galwey Research Fellowship, American Thoracic Society, National Institutes of Health, and the Parker B Francis Research Opportunity Award.
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