- The researchers developed an assessment of the coronavirus based on the results of blood tests for two molecules that could predict severe cases of COVID-19.
- Scientists explain that a more informed prognosis will allow them to adapt treatment accordingly and potentially save many more lives.
- The Dublin-Boston index is the ratio of two cytokines, IL-6 and IL-10. Each 1-point increase was associated with an increased likelihood of serious COVID-19 disease.
The fall led to a revival of the coronavirus in the northern hemisphere, the so-called second wave of COVID-19, which was predicted by medical experts. It̵7;s not just that cold weather and lower humidity contribute to the spread of the virus, which still remains quite stable during the summer months. The virus also benefits people who either feel tired or still deny that the virus exists. Many people still believe that they are safe only because they do not suffer from other diseases or are relatively young. Although COVID-19 usually kills the elderly and those who have suffered from previous illnesses, there are many exceptions to these rules. It is impossible to say what your COVID-19 experience will be if you catch it. And while doctors have made significant progress when it comes to saving lives and reducing deaths, many people are still exposed to complications of COVID-19 on a daily basis.
A group of doctors has developed the first-of-its-kind COVID-19 severity to predict the severity of the disease in humans. Knowing in advance that the patient’s condition is deteriorating, this can be valuable information that can save lives. Doctors will be alerted and may take appropriate measures in the early stages of the disease to try to stop complications before they arrive.
If the Dublin-Boston assessment proves that it can indeed save more COVID-19 patients, it could be one of the biggest breakthroughs in the coronavirus pandemic to date. It can also become as popular as other medical assessments you may be familiar with: the Apgar score, which allows doctors to quickly assess the condition of newborns. As a parent or doctor, you always want this score to be perfect 10, which is a sign that the baby does not need any emergency care after birth.
The Dublin-Boston score is named after the two hospitals that joined the study, RCSI, Harvard University, Beaumont Hospital in Dublin and Brigham and Women’s Hospital in Boston. Their study was published in EBioMedicine from the Lancet (through ScieTechDaily).
This new prognostic score is calculated using the ratio between two markers of inflammation: interleukin-6 (IL-6) and interleukin-10 (IL-10). IL-6 is a pro-inflammatory marker and IL-10 is an anti-inflammatory marker. The assessment attempts to identify fluctuations in cytokines – and the term “cytokine” became quite popular during a pandemic. These are so-called “cytokine storms” that can kill patients by directing the immune response to excessive speed, so it attacks both infected cells and healthy tissues. “Using the inflammatory balance of cytokines as a means to predict results makes a mechanistic sense,” the researchers explain. “Both IL-6 and IL-10 are inextricably linked to cellular metabolism, which in turn is influenced by factors such as infection, severe inflammation, hypoxia and obesity, all of which occur in patients with COVID-19. who need hospitalization. “
“Both the Dublin-Boston score and the 4-day change in the ratio of IL-6: IL-10 significantly exceeded IL-6 alone in predicting the clinical outcome at day 7,” the article said. A study conducted in April showed that elevated levels of troponin and IL-6 were associated with a poor prognosis for COVID-19.
Levels of markers IL-6 and IL-10 change in severe cases of COVID-19. The researchers came up with the relationship between them, as well as the scoring system. Each increase of 1 point means that the heavier result is 5.6 times more often. The higher the score, the worse the prognosis.
The researchers selected 80 patients for the study, and their doctors were blind to IL-6 and IL-10 levels or Dublin-Boston scores when they were visited. Thus, they would not adapt therapy based on these measurements.
“Dublin-Boston scores are easy to count and can be applied to all hospitalized Covid-19 patients,” said Jerry McElvanney, a professor of medicine at RCSI. SciTechDaily. “A more informed forecast can help determine when to start escalating or de-escalating aid, which is a key component of efficient resource allocation during the current pandemic. Evaluation may also play a role in assessing whether new treatments designed to reduce inflammation in Covid-19 are actually beneficial. “
As with other COVID-19 studies, more research may be needed to test whether a Dublin-Boston assessment can save lives. For example, researchers also warn of the risks associated with trying to correct the ratio with treatment. “Although the Dublin-Boston assessment and changes in the ratio of IL-6: IL-10 predict a clinical outcome and give an idea of the pathogenesis of COVID-19 inflammation, we emphasize that these data alone do not support attempts to manipulate the ratio directly as a therapeutic target. Although IL-6 can contribute to organ damage and death in sepsis syndromes, it is also required for innate immunity and clearance. Therefore, inaccurate suppression of anti-inflammatory action may be a double-edged sword.
Whether it works or not, researchers will continue to look for markers that can allow them to predict severe complications of COVID-19. There are already other ideas, including a general blood test, which can predict the severity of the disease.