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Lead study author Gerry McElvaney (left) and co-author Ger Curley in front of RCSI University of Medicine and Health Sciences in Dublin. Image: RCSI
Medical breakthrough: blood test can predict severe course of Covid
Scientists have developed a blood test that may represent a medical advance in the diagnosis and treatment of Covid-19. For the first time, the test is intended to reliably predict which patients infected with SARS-CoV-2 will suffer from a severe form of the Covid-19 disease caused by it. Researchers led by Gerry McElvaney of the RCSI University of Medicine and Health Sciences in Dublin have published their study in “The Lancet” journal EBioMedicine.
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McElvaney and his team, who developed the test with scientists at Harvard University, call it the “Dublin-Boston Score.” The procedure measures the level of the molecules interleukin-6 (IL-6) and interleukin-10 (IL-10) in the blood. Interleukins are cytokines and peptide hormones that act as the body’s own messenger substances in cells of the immune system. The various interleukins specifically stimulate certain cells of the immune system to grow, mature and divide or prevent precisely these processes.
IL-6 and IL-10 control inflammatory responses, IL-6 promotes them, and IL-10 inhibits them. Patients with a severe course of Covid-19 have increased values for both interleukins. The Dublin-Boston score measures the relationship between these two values because it gives significantly better results than measuring the IL-6 value alone. This varies greatly over the course of a day; Furthermore, different patients have different levels of IL-6.
Using the ratio of IL-6 to IL-10, scientists have developed a kind of point system that allows predictions about the future course of the disease. An additional point on this scale corresponds to a 5.6 times greater probability of a severe course.
When using the test, doctors must examine the patient’s blood daily for the first four days. The evaluation then provides a reliable prognosis of the severity of the disease on the seventh day. “The Dublin-Boston score is easy to calculate and can be used on all hospitalized Covid-19 patients,” McElvaney said.
According to a statement from the RCSI, there was no Covid-19 specific prognostic tests that healthcare workers could use to support clinical decision making up to the Dublin-Boston score. The more reliable the prognosis is in the early stage, the better it can be determined when what care is required. This is particularly important in times of a pandemic when resources must be distributed as efficiently as possible.
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