New blood test may predict which COVID-19 patients develop severe infection

Scientists at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences developed a new test that could predict which patients will develop a severe form of the novel coronavirus (COVID-19), according to a new study published in The Lancet 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.

According to the researchers, no COVID-19-specific prognostic scores were available to guide clinical decision-making. The Dublin-Boston score can 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, according to the study.

Based on the changes in the ratio of these two molecules over time, the researchers developed a point system where each one-point increase was associated with 5.6 times increased odds for a more severe outcome.

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 researchers said.

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