Race to identify those most at risk

The COVID-19 virus is deadly for some people and produces little more than a sniffle in others. Still others have the virus without even knowing it.

A vaccine is a long way off, but Australian scientists are fast-tracking the development of a blood test that will help health professionals predict which patients will need intensive care and which will experience only mild symptoms.

The aim is to more accurately predict who will deteriorate quickly and should be admitted and who can be sent home to self-isolate, ensuring limited medical resources are used as appropriately as possible.

The research team from the University of Sydney’s Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead Institute for Medical Research and Nepean Hospital said that developing such a test would usually take more than five years but that the aim was to achieve their goal in five weeks.

The test, which detects a biomarker used to identify high-risk flu patients, has several hurdles to clear before it can be declared an effective predictor for high-risk COVID-19 patients, but the researchers say they have run the test on a handful of blood samples from COVID-19 patients, with “better-than-expected” results.  A crowdfunding campaign has been set up to support the work.

Lead researcher Associate Professor Benjamin Tang said he was cautiously hopeful about the test because it built on a decade of work investigating biomarkers.

The test looks for a single-gene biomarker, IFI27, which indicates a patient is at high risk of influenza. The High-risk Influenza Screening Test (HIST) was developed by Dr Tang after he saw footage of the 2009 swine flu pandemic of overwhelmed emergency departments clogged with patients, The Age reports. The IFI27 gene is released into a patient’s bloodstream, mobilising his or her immune system against the virus.

“When our body is being attacked by the virus, the immune system gets switched on,” said Dr Tang. “When it gets switched on, it starts telling all the other immune cells to come and fight the virus. During that process, the immune system gives out a lot of dangerous signals.

“That is what we’re measuring through this blood test.”

Dr Tang explained that tests currently in use detect the presence of the virus, but not who is most likely to develop life-threatening symptoms.

“It’s not enough just to know that they are infected, we need to know which patient you can send home and which patient you should admit to hospital, or which patient you need to refer to ICU,” he said.

According to international research, about 20 per cent of COVID-19 patients are hospitalised and between five and eight per cent are admitted to intensive care units.

Professor Stuart Tangye at the Garvan Institute told The Age that the test sounded promising, given the IFI27 biomarker test was “very well validated for influenza”.

“It is something potentially to get excited about, but it certainly needs validation in a large number of patients and the data needs to fall out as you would expect it to,” he said.

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