Even as the global health emergency has subsided, COVID-19 continues to pose a threat, with the virus still driving hospitalizations and deaths six years into the pandemic. A new study published this week in The journal of Clinical inquiry Insights offers a potential leap forward in managing the virus’s unpredictable nature, detailing a novel tool for assessing individual patient risk using a simple blood test.Researchers at Inserm and Université Paris Cité have identified a combination of biological markers – including those related to kidney function – that can predict the likelihood of severe outcomes, offering the possibility of more targeted care and resource allocation.
Six years into the COVID-19 pandemic, healthcare systems worldwide continue to grapple with the virus’s ongoing impact. SARS-CoV-2, the virus responsible for the infection, remains actively circulating and contributing to hospitalizations and deaths.
Despite the passage of time, predicting the course and severity of COVID-19 infection remains a significant challenge, ranging from asymptomatic cases to severe and fatal outcomes. Identifying ways to accurately forecast a patient’s likely progression could allow medical professionals to focus resources on those at highest risk.
A new study published January 23 in The Journal of Clinical Investigation Insights demonstrates the effectiveness of a novel predictive tool developed by researchers at Inserm and Université Paris Cité. The tool is designed to assess individual patient risk using a simple blood test.
The tool’s development stems from the discovery, by Inserm researchers Olivia Lenoir and Pierre-Louis Tharaux, of biological markers associated with increased mortality at three months in patients hospitalized with COVID-19 pneumonia, even in cases that were initially mild.
A Statistical Model to Predict Disease Progression at Three Months
Researchers identified these markers by analyzing clinical samples from 196 patients hospitalized across 15 hospitals with moderate to severe pneumonia. Within 48 hours of hospitalization, they measured 41 immune mediators and markers of kidney, endothelial, and vascular damage in the patients’ blood.
All patients were followed for three months to characterize disease progression. Analysis revealed that age and 14 biological markers were associated with the risk of death within 90 days.
Combining two kidney markers and an anti-inflammatory marker with age allowed the researchers to identify patients at the highest risk of fatal complications. They then developed a severity score, called the Corimuno-Score, a statistical model that considers multiple factors. This could help clinicians better triage and manage patients during surges in cases.
“Many studies have already shown the association of certain pro-inflammatory factors with disease severity,” explained Pierre-Louis Tharaux, director of research at Inserm and the study’s last author. “But very few have been able to predict mortality or even transfer to intensive care in patients with initially mild forms, as is the case here.”
These findings could also improve patient selection for clinical trials, leading to more relevant results. The study also highlights the importance of considering the kidneys as sentinel organs in SARS-CoV-2 pneumonia, and potentially in other severe infectious diseases like influenza.“The identified markers could potentially have a predictive interest in the evolution of other severe infectious diseases, particularly viral pneumonias like influenza,” the Inserm concluded in a statement.Photo Adobe Stock
Kidney Involvement Key to Corimuno-Score
“The predictive markers identified in this study had never been previously implicated in COVID-19 and reveal a completely new aspect of the disease—immune, but especially renal,” Tharaux explained. “It is remarkable that the presence of interleukin 10, a classically anti-inflammatory molecule, is more associated with the risk of death than many inflammatory molecules. Similarly, the presence of KIM-1 and LCN2 (kidney markers) demonstrates a previously unnoticed acute kidney injury, often present despite normal kidney function. Acute kidney injury is also a major indicator of the risk of death. Not all patients who die from COVID-19 show kidney injury, but it is the case for a large proportion of them. At this stage, however, it is impossible to say whether these lesions are the cause or the consequence of the deterioration of patients’ health.”
The research team believes these findings will also help refine patient selection for clinical trials, leading to more accurate results. The study underscores the growing understanding of COVID-19’s complex effects on the body, and suggests that the kidneys may play a more critical role in the disease process than previously thought.
