- Researchers have devised a coronavirus score based on blood test results for two molecules that can predict severe COVID-19 cases.
- The researchers explain that a more informed prognosis will allow them to adapt the treatments accordingly and potentially save far more lives.
- The Dublin-Boston score is a ratio of two cytokines, IL-6 and IL-10. Each 1-point increase in score has been associated with an increased likelihood of severe COVID-19.
The fall brought a resurgence of coronavirus on the northern hemisphere, the so-called second COVID-19 wave, which health experts expected. Not only does colder weather and lower humidity favor the spread of a virus that is still quite resistant during the summer months. The virus also benefits from people who either have covid fatigue or who still deny that the virus exists. Many people still think they are safe just because they do not suffer from other medical conditions or are relatively young. While COVID-1
A team of physicians has devised a first of its kind COVID-19 severity to predict the severity of the disease in individuals. Knowing in advance that a patient’s condition is deteriorating can be the kind of valuable information that can save lives. Physicians would be alerted and able to take appropriate action in the early stages of the disease to try to stop the onset of complications before they arrive.
If the Dublin-Boston score shows that it can actually save more COVID-19 patients, it could be one of the biggest breakthroughs in the coronavirus pandemic to date. It can also become just as popular as other medical scores you may be familiar with: Apgar scores, which doctors use to quickly assess the condition of newborn babies. As a parent or doctor, you will always want the score to be a perfect 10, which is an indication that the baby does not need any kind of acute attention after birth.
The Dublin-Boston score is named after the two hospitals that contributed to the research, RCSI, Harvard University, Beaumont Hospital in Dublin and Brigham and Women’s Hospital in Boston. Their study was published in Lancets EBioMedicine (via ScieTechDaily).
This new prognostic score is calculated using a ratio of two markers of inflammation: interleukin-6 (IL-6) and interleukin-10 (IL-10). IL-6 is a proinflammatory marker and IL-10 is anti-inflammatory. The score tries to determine cytokine fluctuations – and the term “cytokine” has been made very popular during the pandemic. It is the so-called “cytokine storms” that can kill patients and send the immune response to overdrive, attacking both infected cells and healthy tissue. “Using inflammatory cytokine balance as a means of projecting the outcome makes mechanistic sense,” the researchers explain. Both IL-6 and IL-10 are inextricably linked to cell metabolism, which in turn is affected by factors such as infection, severe inflammation, hypoxia and obesity, all of which are seen in patients with COVID-19 in need of hospitalization. ”
“Both the Dublin-Boston score and the 4-day change in IL-6: IL-10 ratios significantly surpassed IL-6 alone by predicting clinical outcome on day 7,” the paper reads. A April study showed that elevated troponin and IL-6 levels are associated with a poor COVID-19 prognosis.
The levels of IL-6 and IL-10 markers change in severe COVID-19 cases. The researchers came up with the relationship between them as well as a point system. Each increase of 1 point means that a more serious result is 5.6 times more likely. The higher the score, the worse the prognosis.
The researchers selected 80 patients for the study, and their treating physicians were blind to the levels of IL-6 and IL-10 or Dublin-Boston scores while participating in them. In this way, they would not adapt the therapies based on these measurements.
“The Dublin-Boston score is easily calculated and can be applied to all inpatient Covid-19 patients,” said RCSI Professor of Medicine Gerry McElvaney SciTechDaily. “More informed forecasting can help determine when to escalate or de-escalate care, a key component in the efficient allocation of resources during the current pandemic. The score may also play a role in assessing whether new therapies designed to reduce inflammation in Covid-19 actually provide benefits. ”
As with other COVID-19 studies, more research may be needed to see if Dublin-Boston scores can save lives. For example, researchers also warn against the risks associated with trying to correct the value of the treatment relationship. “While Dublin-Boston scores and changes in IL-6: IL-10 ratios both predict clinical outcome and provide insight into the pathogenesis of COVID-19 inflammation, we emphasize that these data alone do not support attempts to manipulate the relationship directly as a therapeutic goal. Although IL-6 can contribute to organ damage and death in sepsis syndromes, it is also necessary for innate immunity and microbial clearance. Precise inhibition of the pro-inflammatory effects may therefore represent a double-edged sword. ”
Whether or not it works, researchers will not stop looking for markers that may allow them to predict serious COVID-19 complications. There are already other ideas, including a regular blood test, that can predict the severity of the disease.