COVID-19: UBC research shows how blood tests can predict patient outcomes


Analyzing blood markers when a patient is hospitalized with COVID can help doctors predict who will have the worst outcomes, study finds

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Researcher Kelly McNagny wasn’t working in the field of new and dangerous viruses when the pandemic hit more than two years ago.

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His team at the University of B.C.’s School of Biomedical Engineering was actually developing new blood-test technology to help doctors predict which children are likely to have issues with allergies.

But when the coronavirus swept the globe and started filling up hospitals and intensive care units, “We realized that the same toolkit could be applied to COVID patients,” McNagny said by phone this week.

“Can we predict whether they’re going to recover soon?” Or are they liable to require a longer, more worrisome stay in intensive care? The team hoped digging into biomarkers on blood cells would help make those predictions easier.

The UBC team’s research, published in pre-print recently, suggests blood tests administered when a COVID patient hits an ICU could help doctors identify patients likely to be in intensive care for six days or less, and those who are headed for longer, more complex stays, or even risk death.

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In other words, “the ones we have to watch like a hawk.”

medrxiv.org
medrxiv.org

The blood tests could help indicate who is at risk of what is known as a “cytokine storm” — a dangerous infectious reaction that sets off systemic inflammation and a rapid downturn in a patient’s condition.

The tests could allow ICU physicians to steer treatments toward those patients who are most likely to need them, while also preventing overtreatment of those who are bound to recover more quickly.

The UBC team just released research identifying dozens of markers on blood cells that can be used as a “predictive tool” as to whether a COVID patient is predisposed to the kinds of complications that could lead to a long stay in ICU.

McNagny calls the markers “the needle in a haystack.” The blood tests wouldn’t need to be done on all the markers to be useful in a therapeutic setting, but could be done on perhaps three or four. And the technology needed to do those tests is already available in most hospitals, he noted.

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While the research hasn’t been peer reviewed and is still being considered by a top medical journal, other recent studies have found similar success using biomarkers to classify COVID patients.

McNagny sees that as an indication they are on the right path, and hopes the research can move quickly toward clinical application while the pandemic rages on.

“Past attempts at predicting disease severity using biological markers have all ultimately fallen short,” said the researchers in a news release. “This is the first clinical measurement with enough prognostic power to be effective. It’s also possible with equipment already found in most hospitals.”

“When a patient lands in the ICU, we dial up the treatments they’re getting,” said McNagny. “But for people who are likely to have a short stay, some medication may actually slow their recovery. Instead of a one-size-fits-all approach, we may be able to use this test to tailor treatment according to their prognosis.”

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McNagny was quick to note the research required a big team, and specifically praised Dr. Don Sin, who heads the Centre for Heart Lung Innovation at St. Paul’s Hospital and provided crucial patient samples early in the pandemic, as well as Dr. Myp Sehkon from the intensive care unit at Vancouver General Hospital, and co-authors Kevin Leslie and Melina Messing.

CORRECTION: An earlier online version of this story misspelled Melina Messing’s first name. We apologize for the error.


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