Course of disease in Covid-19 – The search for the key marker


Especially in the east of the country, the hospitals are currently overcrowded with Covid-19 patients. Operations have to be postponed, and there are hardly any beds available in intensive care units. A person infected with the Sars-CoV-2 coronavirus can have a relatively protracted, even serious, disease course, which results in a long hospital stay. Predictions of how this will develop are already possible. Some parameters, such as those collected in the clinic, can point to more favorable or worse courses, but not very precisely. Doctors therefore lack a basis for making decisions about when they can discharge their patients, sometimes even early.

Alice Assinger from the Institute for Vascular Biology and Thrombosis Research at the Center for Physiology and Pharmacology at the Medical University of Vienna is about to find a biomarker that can reliably predict the course of the disease. This would not only improve the situation of the patients, but also relieve the daily hospital routine. In an interview with the “Wiener Zeitung”, the scientist outlines her research, for which she recently received financial support from the FWF Science Fund as part of the Sars-CoV-2 acute funding.

microRNAs in sight

There are certain parameters such as the inflammation value C-reactive protein (CRP), the creatinine value, which reflects the kidney function, the number of blood platelets (thrombocytes), but also age, which play a major role in Covid-19. Assinger explains that the course of an infection can now be determined with relative accuracy in the first four days. Since January, hospital doctors have been able to use the ACCP tool (Age + C-reacitve protein + Creatinine + Platelet) developed by the team of scientists, which provides the corresponding results via an online calculator.

Research is currently being carried out on an even earlier prediction of the course of the disease, and it is also unclear whether the same behavior occurs in the case of mutations.

As part of an international collaboration, the researcher is now trying to find biomarkers circulating in the blood where the course of the disease can be read. The focus is on the microRNAs. These building blocks play an important role in the complex network of gene regulation. They determine how the cells generate their proteins and also determine how the cell functions.

These microRNAs are bound to so-called lipids – fat globules – in human blood and pass on information from cell to cell. “Only with a few drops of blood can we prove information that a certain organ has given up, for example,” explains Assinger.

Relief for the hospitals

This has already been achieved in another project “where we looked at the regeneration potential of the liver”. In 2019, the team of scientists actually managed to find a meaningful biomarker that can answer this question. Whether the liver can regenerate well is particularly important for tumor patients who have had part of the organ to be removed in the course of an operation.

The researchers do not currently have a specific microRNA as a biomarker for Covid-19 in their sights. “We look at the entire pool of microRNAs, compare them in patients with a severe and mild course and then filter out the differences.”

Alice Assinger has been researching new biomarkers since the beginning of the corona pandemic and works closely with the Favoriten Clinic, the Medical University of Innsbruck, the Johannes Kepler University Linz and the Karolinska University Hospital in Stockholm. Birmingham is now also on board as a research facility. A reliable prognosis could not only help to ensure that patients can be cared for more individually, but also to ensure that beds in hospitals are free again earlier.

At least this approach is plausible for Austria. Sweden, where the bed capacity per capita is much lower than in Germany, is pursuing the same goal – albeit with a different sign. There, with the help of a meaningful biomarker, it should be possible to make it easier in advance to decide whether a patient has to go to a hospital at all or whether the infection can also be cured at home.

“We hope to learn more about the disease itself with our research. This knowledge could ultimately lead to new treatment methods,” says Assinger.

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