Blood Test Can Predict Severity of COVID-19

Doctors can now identify COVID-19 patients having the highest risk of severe illness and pinpoint those most likely to need a ventilator by simply examining their blood.

This discovery by researchers from the University of Virginia (UVA) School of Medicine (Charlottesville, VA, USA) could lead to new treatments for the prevention of deadly “cytokine storms” seen in severe cases of COVID-19. It also may help explain why diabetes contributes to worse outcomes in patients with the coronavirus.

Cytokines – proteins produced by immune cells – are responsible for severe overreactions by the immune system, known as cytokine storms, associated with COVID-19 and other serious illnesses. Cytokine storms are typically associated with an established group of cytokines. The researchers identified 57 COVID-19 patients treated at UVA who ultimately required a ventilator and then tested their blood samples within 48 hours of diagnosis or hospital admission. They compared the results with those from patients who did not end up needing a ventilator. The researchers found that the best predictor of COVID-19 outcomes was an “underappreciated” cytokine more associated with allergies. High levels of that cytokine, IL-13, were associated with worsened COVID-19 outcomes regardless of patients’ gender, age or other health problems.

The researchers also identified two more cytokines associated with severe outcomes, though the duo had less ability to predict the need for a ventilator. The researchers say the discovery could become part of a scoring system to let doctors flag up at-risk COVID-19 patients for closer monitoring and personalized interventions. In addition, the researchers found that levels of two other cytokines were significantly higher in patients with elevated blood sugar. This “proinflammatory response” could help explain why diabetes is associated with worse COVID-19 outcomes, according to the researchers.

“The immune response that we discovered to predict severe shortness of breath in COVID-19 is known in other pulmonary diseases to cause damage. So this could lead to a novel way to prevent respiratory failure in individuals infected with the new coronavirus, by inhibiting this immune cytokine,” said Bill Petri, MD, PhD, of UVA’s Division of Infectious Diseases and International Health. “We plan to test this in a model of COVID-19 prior to considering a clinical trial.”

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University of Virginia School of Medicine