The UK has been hit very hard in this wave of COVID-19. There is a dire need to distinguish why a few patients with the virus do quite well, whereas others should be admitted to intensive care and may kick the bucket from the disease.
A new study called DISCOVER (DIagnostic and Severity markers of COVID-19 to Enable Rapid triage) sought to identify markers that predict how COVID-19 affects patients. Clinicians and academics are leading the study at North Bristol NHS Trust and the University of Bristol.
The study mainly focused on blood-based biomarkers and their ability to predict a patient’s disease course alongside demographic factors such as age, sex, frailty, and other medical conditions.
When patients with suspected or affirmed COVID-19 are admitted to the hospital, they will be drawn closer by the scientists and assented for blood sampling and access to their medical history. These patients will, at that point, be followed awake for 28 days, remotely, and their clinical progress recorded. Blood tests from the study will be stored anonymously for future research.
One biomarker the research team will test is suPAR (soluble urokinase plasminogen activating receptor), which has already had encouraging results from Greek data, alongside other more conventional tests, such as troponin, NT-proBNP and ferritin.
The group will likewise test an assortment of molecules that control the immune system, known as “cytokines.” This is significant as, although most of the patients with COVID-19 recover rapidly, right now, specialists don’t yet realize an ideal approach to anticipate which patients to keep in the hospital to monitor all the more closely. This early triage of patients is significant to deal with the pressure on hospital beds securely.
Dr. David Arnold, at North Bristol NHS Trust and NIHR Doctoral Research Fellow in the Bristol Medical School: (THS), said: “We hope to rapidly publish this work and share our results with the other UK and international centers to allow wider use of successful prognostic biomarkers. Our study could help doctors in the future decide which tests are useful in managing coronavirus and which are not.”
Dr. Fergus Hamilton, Honorary Research Fellow in the Bristol Medical School: (PHS), added: “One of the key strengths of DISCOVER is that despite the rapid speed of application, ethical approval, and data collection, plans were made early to collaborate with both local and national researchers to ensure that any samples or data collected will be available to ensure the benefit to the wider research community, and ultimately, to patients. We have developed many collaborations over a short period, including with the UNCOVER group and Public Health England.”
Collaborations include:
- Development and testing of antibody testing (or ‘immunity passports’);
- Developing techniques to measure drug levels for potential treatments for COVID-19;
- Finding ways to measure live virus in the blood (with one of only two labs in the UK authorized to work with SARS-CoV-2);
- Understanding the ‘microbiome’ of COVID-19 patients in the intensive care unit;
- Measurement of whether patients with cancer have a different immune response to COVID-19;
- Testing whether patients’ genes (or how they are activated) affects the response to COVID-19.