New blood test predicts which COVID-19 patients will develop severe
infection
Test could inform doctors on best treatment options

Date:
October 14, 2020
Source:
RCSI
Summary:
Scientists have developed a score that can accurately predict
which patients will develop a severe form of COVID-19.



FULL STORY ========================================================================== Scientists have developed, for the first time, a score that can accurately predict which patients will develop a severe form of Covid-19.


==========================================================================
The study, led by researchers at 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 when identifying patients who
may benefit from therapies, such as steroids, and admission to intensive
care units.

Until this study, no Covid-19-specific prognostic scores were available
to guide clinical decision-making. The Dublin-Boston score can now
accurately predict how severe the infection will be on day seven after measuring the patient's blood for the first four days.

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.

Based on the changes in the ratio of these two molecules over time,
the researchers developed a point system where each 1-point increase
was associated with a 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," said RCSI Professor of Medicine
Gerry McElvaney, the study's senior author and a consultant in Beaumont Hospital.

"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 actually provide benefit." 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 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 the course of any given day, and the magnitude
of the IL- 6 response to infection varies between different patients.

The Dublin-Boston score was developed by researchers from RCSI, Harvard University, Beaumont Hospital in Dublin and the Brigham and Women's
Hospital in Boston.


========================================================================== Story Source: Materials provided by RCSI. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Oliver J McElvaney, Brian D Hobbs, Dandi Qiao, Oisi'n F McElvaney,
Matthew Moll, Natalie L McEvoy, Jennifer Clarke, Eoin O'Connor,
Sea'n Walsh, Michael H Cho, Gerard F Curley, Noel G McElvaney. A
linear prognostic score based on the ratio of interleukin-6 to
interleukin-10 predicts outcomes in COVID-19. EBioMedicine, 2020;
61: 103026 DOI: 10.1016/j.ebiom.2020.103026 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/10/201014114106.htm

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