Scientists have developed, for the first time, a score that can accurately predict which patients will develop a severe form of Covid-19. The study, led by researchers at RCSI (Royal College of Surgeons in Ireland) University of Medicine and Health Sciences, was published published online on October 8, 2020 in The Lancet's translational research journal EBioMedicine (https://doi.org/10.1016/j.ebiom.2020.103026). The open-access article is titled “A Linear Prognostic Score Based on the Ratio of Interleukin-6 to Interleukin-10 Predicts Outcomes in COVID-19.” 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. Until this study, no COVID-19-specific prognostic scores were available to guide clinical decision-making. The Dublin-Boston score can now 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. Based on the changes in the ratio of these two molecules over time, the researchers developed a point system where each 1-point increase was associated with a 5.6 times increased odds for a more severe outcome. "The Dublin-Boston score is easily calculated and can be applied to all hospitalized COVID-19 patients," said RCSI Professor of Medicine Gerry McElvaney, the study's senior author and a consultant in Ireland’s Beaumont Hospital.
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