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Covid-19: Markers for predicting lung failure identified

Covid-19: Markers for predicting lung failure identified



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Prediction of lung failure in COVID-19 sufferers

Although many infections with the novel coronavirus SARS-CoV-2 are harmless or even without symptoms, some of the infected people develop severe disease. Severe lung damage is often found in these patients. Researchers from Munich are now reporting on a marker for predicting severe COVID-19 courses.

In a pilot study, doctors at the University of Munich Clinic (LMU) were able to show that the messenger substance interleukin-6 is increased in patients with severe COVID-19 courses and that the blood level is very likely to indicate the need for an intensive stay early.

COVID-19 disease takes a very different course

The COVID-19 disease can take a very different course for patients.

According to a current report from the clinic, it is very helpful for doctors to recognize early on which COVID-19 patients are at risk of lung failure.

These patients could then be monitored intensively. In return, patients without risk characteristics can be treated in the normal ward or even at home.

In this way, places in intensive care units can be spared and allocated to those who really need them.

In a study, scientists at the LMU Clinic in Munich have now found so-called biomarkers that enable this distinction to be made. The results were recently published in the journal "Journal of Allergy and Clinical Immunology".

Impending overload of the capacities of the intensive care units

Most people become easily ill and recover quickly after infection with the SARS-CoV-2 coronavirus. In about five percent of the sufferers, however, there is a severe course of the disease with shortness of breath.

Some of these patients require artificial respiration in the intensive care unit. With a rapidly increasing number of infections, the capacities of the intensive care units could be overloaded.

"We saw many patients with COVID-19 in our emergency room in March and April and had to decide which of the patients was expected to have a severe course of the disease," said PD Dr. med. Tobias Herold and Dr. Tobias Weinberger, senior physician at the Central Emergency Department (ZNA) on the Großhadern campus of the LMU Clinic.

In order to identify patients who are at risk of deteriorating, "we need markers that predict the clinical course".

Prediction with high accuracy

Together with colleagues from the LMU Clinic, PD Dr. In a pilot study, Tobias Weinberger examined the clinical course and laboratory parameters of 89 COVID-19 sufferers who had to be treated in hospital due to the severity of the disease.

From this group, 32 people - mostly men - had to be artificially ventilated.

All of these patients were found to have elevated levels of an inflammatory marker, IL-6, in the blood. Even more: "An IL-6 value of over 80 picograms / milliliter and a CRP value of over 9.7 milligrams / deciliter during the disease predicted the later lung failure with high accuracy," explains Dr. Tobias Herold.

The risk of lung failure was many times higher for patients with higher values.

Medicines could possibly have a positive effect on the course of the disease

Internationally there is a great need for such knowledge and the scientific interest is currently great.

According to experts, it is still unclear whether IL-6 is a central factor in the widespread disease in the lungs or just a marker of disease activity.

If the former is true, drugs that intervene in this inflammatory process could have a positive effect on the course of the disease. In order to answer this question, the COVACTA study is currently also being carried out at the LMU Clinic. It tries to slow down the escalating inflammatory process. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Swell:

  • University of Munich Clinic (LMU): Prediction of lung failure in patients with COVID-19, (accessed: May 26, 2020), University of Munich Clinic (LMU)
  • Tobias Herold et al .: Elevated levels of interleukin-6 and CRP predict the need for mechanical ventilation in COVID-19; in: Journal of Allergy and Clinical Immunology, (published: 18.05.2020), Journal of Allergy and Clinical Immunology


Video: Update on Understanding Pathology and Mangement of Respiratory Failure in COVID 19 Patients (August 2022).