A new study has shown that doctors can identify, via blood samples, those at greater risk of severe illness after being diagnosed with coronavirus, including those who may need a ventilator, according to research from the University of Virginia School of Medicine (UVA) released on Monday.
The discovery, according to the research, can lead to preventative treatments in stopping deadly “cytokine storms” (severe immune system reactions) commonly seen in serious cases of COVID-19, while also serving as an explanation for why diabetics encounter more obstacles in coronavirus treatment.
Accordingly, scientists at UVA found that the levels of a particular cytokine in the blood after a patient is diagnosed with coroanvirus is predictive of virus severity. These cytokines, proteins produced by immune cells, are responsible for severe immunological responses in the body.
The value of this discovery is rooted in its potential for establishing a systematic process, or scoring systems, of 'red flags' of illness severity depending on the particular health profile of the COVID-19 patient, allowing for more personalized treatment and a better allocation of medical resources. Similarly, new treatments that target the impacted cytokines can be developed based on the research's findings.
“The immune response that we discovered to predict severe shortness of breath in COVID-19 is known in other pulmonary diseases to cause damage. So this could lead to a novel way to prevent respiratory failure in individuals infected with the new coronavirus, by inhibiting this immune cytokine,” said Bill Petri, MD, PhD, of UVA’s Division of Infectious Diseases and International Health.
He added that “We plan to test this in a model of COVID-19 prior to considering a clinical trial.”
Cytokine storms, whereby the immune system overreacts and causes damage to the body and vital organs, are associated with a particular group of cytokines. The UVA scientists found that the best predictor of potential coronavirus outcomes was an “underappreciated” set of cytokines associated with allergic response. It was found that high levels of the cykotine IL-13 was associated with severe COVID-19 illness regardless of the age, gender or other health problems of diagnosed patients.
Furthermore, the researchers also identified two more cykotines associated with illness severity in patients with elevated blood sugar, but they were not predictive of the need for ventilators in these patients. This “proinflammatory response,” according to the research, can act as an explanation of more severe outcomes in diabetic COVID-19 patients.
The researchers came to their conclusions after testing the blood samples of 57 COVID-19 patients at UVA, who later required a ventilator, while comparing the results to those not requiring a ventilator following their COVID-19 diagnoses.
The discovery can give new insights into severe immunological reactions, and can be potentially life-saving.
“This work was led by Allie Donlan, Mary Young and Mayuresh Abhyankar in my lab,” Petri said.
“But it was also a huge team effort by the School of Medicine with the support of iTHRIV and the Global Infectious Diseases Institute,” he said.