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Could a blood test predict whether coronavirus will kill you?

Researchers at George Washington University (GWU) believe that a simple blood test could predict which coronavirus patients could become deathly ill. 

The scientists have identified five biomarkers that indicate risks of complications like inflammation and bleeding disorders that make someone more likely to die if they contract coronavirus. 

High levels of two of these blood indicators, in particular, are linked to far greater odds of dying from the infection. 

The GWU team believes a blood test for these biomarkers could give doctors a clearer picture of who might need ventilator support or early aggressive treatment with a more finely tuned tool than general risk factors like age and underlying conditions. 

People over the age of 65 and those with underlying conditions are typically less able to fight off any infection, not just COVID-19. 

But coronavirus has proven deadly to scores of otherwise healthy, relatively young people too – and scientists are still not sure exactly why some COVID-19 patients quickly spiral downward and others have no symptoms at all. 

And knowing who might need the most aggressive care is critical for hospitals when the threat of drug and supply shortages looms. 

New York City narrowly avoided a shortage of ventilators when it became the global epicenter of the pandemic in March and April. 

Several hospitals in hard-hit parts of Texas completely ran out of beds for coronavirus patients (or others) as cases spiked there in June and July. 

Even though Texas and other sunbelt states are seeing fewer new cases per day, hospitalization rates remain high. Florida reported a new record high number of coronavirus deaths in a single day on Tuesday and cases continue to climb in states like Georgia, Alabama, Illinois and Illinois. 

And nationwide, there are still shortages of drugs needed for patients on mechanical ventilators and of the only FDA-authorized treatment, remdesivir. 

Treating any and all patients sick enough to need to be hospitalized as early as possible is the best course of action – but it’s also a luxury doctors may not have the needed supplies are so precious. 

Grim though it may sound, health care providers may have to choose for one patient to get treatment over another – and a blood test could make these decisions both easier and more likely to be the correct ones.  

‘When we first started treating COVID-19 patients, we watched them get better or get worse, but we didn’t know why,’ said Dr Juan Reyes, study co-author and assistant professor at GW School of Medicine.

‘Some initial studies had come out of China showing certain biomarkers were associated with bad outcomes. There was a desire to see if that was true for our patients here in the US.’ 

The data that Dr Reyes and his colleagues saw out of China inspired them to assess the blood levels of five biomarkers in COVID-19 patients at GW Hospital. 

The biomarkers they looked at were: 

Of the 299 COVID-19 patients whose blood they tested, the researchers found all five biomarkers in 200. 

Patients with higher levels any or all of these biomarkers were more likely to need to be treated in the ICU or put on ventilators. 

High LDH levels (greater than 1200 units/l) or high D-dimer levels (greater than 3 μg/ml) predicted the greatest risks that patients would die of coronavirus. 

‘We hope these biomarkers help physicians determine how aggressively they need to treat patients, whether a patient should be discharged, and how to monitor patients who are going home, among other clinical decisions,’ said Dr Shant Ayanian, an assistant professor and the study’s first author. 

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