- The researchers developed a coronavirus marker based on blood test results for two molecules that could predict severe cases of COVID-19.
- Scientists explain that a more informed prognosis will allow them to adapt treatments accordingly and potentially save many lives.
- The Dublin-Boston score is a ratio between two cytokines, IL-6 and IL-10. Each 1-point score increase was associated with an increased likelihood of severe COVID-19.
The fall brought a resurgence of the coronavirus to the northern hemisphere, the so-called secondary COVID-19 wave expected by health experts. It is not only the colder weather and lower humidity that favor the spread of a virus that is relatively resilient during the summer months. The virus also takes advantage of people who may have covid fatigue or who still deny the virus. Many people still think they are safe just because they do not suffer from other medical conditions or are relatively young. While COVID-19 generally kills older people and those with pre-existing conditions, there are many exceptions to those policies. There is no way to tell how your COVID-19 experience if you catch it. And while doctors have made significant progress when it comes to saving lives and reducing the number of deaths, many people still succumb to the complications of COVID-19 on a daily basis.
A team of doctors developed the first type of severity score COVID-19 to predict the severity of the disease in individuals. Knowing in advance that the patient’s condition is about to worsen may be some kind of important information that can save lives. Doctors will be warned and may take appropriate steps in the early stages of the disease to try to stop the onset of complications before they arrive.
If the Dublin-Boston score proves it can save more COVID-19 patients, it could be one of the biggest successes to the coronavirus pandemic so far. It can also be as popular as other medical marks you may be familiar with: the Apgar mark that doctors use to diagnose the condition of newborns quickly. As a parent or doctor, you always want that mark to be a perfect 10, which is an indication that the baby does not need any kind of emergency attention after birth.
The Dublin-Boston mark is named after two research-contributing hospitals, RCSI, Harvard University, Beaumont Hospital in Dublin, and Brigham and Women’s Hospital in Boston. Their study was published in Lancet’s EBioMedicine (by ScieTechDaily).
This new prognostic score was calculated using a ratio between two markers of inflammation: interleukin-6 (IL-6) and interleukin-10 (IL-10). IL-6 is an inflammatory marker and IL-10 is anti-inflammatory. The score attempts to determine cytokine variability – and the term “cytokine” was made popular during the pandemic. These are the so-called “cytokine storms” that can kill patients, sending the immune response to excessive movement thus attacking both infected cells and healthy tissues. “Using the inflammatory cytokine balance as a means to produce an outcome makes sense in the mechanism,” the researchers explained. “Both IL-6 and IL-10 are not directly related to cell metabolism, which is influenced by factors such as infection, severe inflammation, hypoxia, and excess weight, all of which are encountered in patients. with COVID-19 in need of hospitalization. “
“Both the Dublin-Boston score and the 4-day change in IL-6: IL-10 ratio significantly exceeded IL-6 alone in predicting clinical outcome on day 7,” the paper reads. A study from April indicated that elevated levels of troponin and IL-6 were associated with a poor COVID-19 prognosis.
Levels of IL-6 and IL-10 scores vary in acute COVID-19 cases. The researchers came up with the ratio between them as well as a point system. Each 1-point increase means that a more severe outcome is 5.6 times more likely. The higher the score, the worse the prognosis.
The scientists selected 80 patients for the study, and their treatment of physicians was blind to IL-6 and IL-10 levels or the Dublin-Boston score while attending them. This way, they do not fit therapies based on measurements.
“The Dublin-Boston score is easy to calculate and can be applied to all hospitalized Covid-19 patients,” said RCSI Medical Professor Gerry McEʻikeey SciTechDaily. “More informed prognosis can help determine when to raise or increase care, a key component of efficient allocation of resources to the current pandemic. The score may also play a role in evaluating whether new therapies designed to reduce inflammation with Covid-19 really provides benefits. “
As with other COVID-19 studies, more research may be needed to determine if the Dublin-Boston score can save lives. For example, researchers also warn of the risks involved in attempting to correct the value of the treatment ratio. While the Dublin-Boston score and changes in IL-6: IL-10 ratio both predict clinical outcome and provide an insight into the pathogenesis of COVID-19 inflammation, we emphasize that this data alone does not support attempts to manipulate the ratio directly as a therapeutic target.Although IL-6 may contribute to organ damage and death of sepsis syndromes, it is also necessary for natural immunity and microbial clearance. “Improper suppression of inflammatory effects may represent a double-edged sword.”
Whether they do or not, researchers will not stop looking for markers that may allow them to predict the serious complications of COVID-19. Other ideas already exist, including a standard blood test that can predict the severity of the disease.