The test could inform doctors about the best treatment options.
Scientists have developed, for the first time, a score that can accurately predict which patients will develop severe Covid-1
The study, led by researchers from RCSI University of Medicine and Health Sciences, is published in The LancetTranslational Research Journal EBioMedicine.
The measurement, called the Dublin-Boston score, is designed to enable physicians to make more informed decisions in 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 the severity of the infection on the seventh day 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 another, called IL-10, is anti-inflammatory. Levels of both are altered in severe Covid-19 patients.
Based on 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 greater probability for a more severe outcome.
“The Dublin-Boston score is easily calculated and can be applied to all hospitalized patients with Covid-19,” said RCSI medicine professor Gerry McElvaney, senior author of the study and consultant at Beaumont Hospital.
“A more informed prognosis could help determine when to increase or decrease care, a key component of efficient resource allocation during the current pandemic. Scoring may also play a role in assessing whether new therapies designed to reduce inflammation in Covid-19 actually provide benefits. “
The Dublin-Boston score uses the ratio of IL-6 to IL-10 because it significantly outperformed the measurement of variation in IL-6 alone.
Despite the high blood levels, the use of IL-6 measurements alone as a prognostic tool for Covid-19 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 outcomes in COVID-19“By 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 and Noel G McElvaney, October 8, 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.