Test predicts whether corona patient will become very ill

A new computer analysis of a standard blood test predicts with great accuracy whether a corona patient will become seriously ill. Based on this, doctors can quickly make decisions about triage, monitoring and treatment. This is reported by a consortium of European researchers in the online magazine eLife: https://elifesciences.org/articles/63195#sa2

Blood analysis is a standard part of many medical examinations, including the hospitalization of corona patients. This analysis produces a so-called blood picture. That is a complete overview of the relative amounts of different types of cells circulating in the blood: red and white blood cells and platelets. With new techniques, researchers can further characterize these cells. For example, they can see whether a cell is activated and how the bone marrow responds to inflammation.

The blood picture of 982 corona patients in eleven Dutch, Belgian and Italian hospitals showed striking patterns. The researchers assigned a ‘prognostic score’ to this. On day 1, it predicted with 75 percent accuracy who would need treatment in the ICU; that accuracy increased to 87 percent on Day 3 and 93 percent on Day 6.

Very practical score

Previous studies had already concluded that certain blood values ​​correlate with the disease course of Covid-19. “But many of them show a certain bias in their design ”, says André van der Ven, professor of international health at the Radboudumc in Nijmegen and lead author of the study. “Sometimes the outcome was poorly defined or the findings were not validated in an independent group of patients. On the other hand, we figured out in advance what exactly we were going to focus on and wanted the outcome to be a very practical score. Moreover, we have validated our results. All this makes our research unique. ”

Another difference is that many of the earlier studies use blood parameters that are not part of the standard package in many hospitals. “We wanted to use the test that is administered to patients everywhere, including in countries such as Brazil, South Africa and Indonesia,” emphasizes Van der Ven. “The results are automatically analyzed by software that researchers can install on their laboratory equipment. Devices from all common manufacturers are suitable for this. ”

The software not only analyzes the numbers, but also the degree of activation of white blood cells, such as lymphocytes, neutrophils and monocytes. “It is striking that seriously ill corona patients also have very young red and white blood cells in their blood: the so-called erythroblasts and immature granulocytes,” says Van der Ven. “In a healthy person you will only find it in the bone marrow, not in the blood.”

Local hospital

Typically, blood cell characterization is done in a flow cytometer: a complex instrument requiring a great deal of specialist expertise. The equipment that measures the blood picture is much simpler and also cheaper. Is that equipment also in a local hospital in Indonesia? “Yes”, answers Van der Ven. “It’s standard.”

The recognition software will be available worldwide at the end of January. “There is already great interest in this from the Dutch hospitals,” says Van der Ven, “and other countries have already come forward. On this basis, doctors can say within a few minutes: we can send this patient home. Or: oh dear, we have to keep a close eye on these and maybe give heavier medicines. ”

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