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Prediction of lung failure in patients with COVID-19

Published online: May 18, 2020

The SARS-CoV-2 infection can take different courses for patients. It is helpful for medical professionals to recognize early which COVID-19 patients are at risk of lung failure. These patients could then be monitored closely. 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 assigned to those who really need them. Additionally, treatment intensification can be provided to those that are at highest risk. In a study, scientists from LMU University Hospital Munich have now found so-called biomarkers that make this possible.

In an original article recently published in The Journal of Allergy & Clinical Immunology (JACI), Herold and colleagues describe results of a study of the clinical course and laboratory parameters of 89 patients with COVID-19 who had to be treated in hospital due to the severity of the disease. From this group, 32 patients - mostly men - had to be ventilated. It was found that they all had elevated levels of an inflammation marker in the blood. An IL-6 value of over 80 pg/mL and a CRP value of over 9.7 mg/dL during the disease predicted the development of lung failure with high accuracy. The risk of lung failure was many times higher for patients with elevated values. IL-6 levels predicted respiratory failure earlier than CRP-levels.

There is currently a great need for such knowledge. It is unclear whether IL-6 is a central factor of the spreading disease in the lungs or just a marker of disease activity. If the former applies, drugs that intervene in this inflammatory process could have a positive effect on the course of the disease. Additionally, measurement of IL-6 followed and CRP might be pivotal for risk-adapted escalation of treatment.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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