Intermountain Healthcare Researchers Develop New Diagnostic Tool To Identify & Treat Covid-19 Patients At Risk Of Severe Illness, Death Due To Inflammatory Disorder

Published : 05 Oct 2020

Researchers at Intermountain Healthcare in Salt Lake City have developed a new clinical tool to accurately identify and diagnose COVID-19 patients who are at high risk of developing a serious inflammatory condition that can damage the lungs and other organs.

The new tool is a diagnostic clinical score that is used to determine whether patients with the virus are at increased risk of developing the condition, known as a hyperinflammatory syndrome, also sometimes referred to as a "cytokine storm." This condition causes the immune system to react inappropriately and excessively causing damage to organs.

Diagnosing this hyperinflammatory syndrome is very important. With the new scoring diagnostic criteria, clinicians can now identify patients early and ideally prescribe treatments before the condition progresses and causes patients to deteriorate to critical levels.

Researchers studied the accuracy of the diagnostic tool as part of a new study that is published in today's issue of the British medical journal, The Lancet Rheumatology.

For the study, researchers applied the new cHIS diagnostic score to 299 patients admitted to Intermountain hospitals with severe COVID-19. They found that that the criteria accurately identify patients who are at high risk for deteriorating clinically and requiring high oxygen supplementation, going on the ventilator, or dying.

Researchers also found that COVID-19 patients with elevated cHIS criteria were four times more likely to progress to need the ventilator for respiratory support.

"The prognostic value of the cHIS score is important because it can help doctors identify patients who are at risk of progressing to much more severe disease before it happens," said Brandon Webb, MD, an infectious disease physician at Intermountain Healthcare and principal investigator of the study.

Samuel Brown, MD, critical care physician at Intermountain and co-investigator on the study, says the knowing which COVID-19 patients who are vulnerable to the hyperinflammatory syndrome, will also help enhance treatment in other ways.

"The cHIS score is also important in two other ways," explained Dr. Brown. "First, it will help us to design clinical trials targeting the patients for whom new drugs are most likely to work, and secondly, it allows us to now tailor our treatment strategy to give the right drugs to the right patients who are most likely to benefit."

In an accompanying editorial published with the study in The Lancet Rheumatology, written by Drs. Randy Cron, Grant Schubert, and Rachel Tattersall, they praised the work done by the Intermountain team.

"Dr. Webb and colleagues are the first to report cytokine storm syndrome clinical criteria specific to COVID-19 in the form of cHIS," the editorial said. "Importantly, these criteria are relatively standard assessments that are readily available, timely, and not cost-prohibitive for most countries. These criteria will need validation, but for now, should help clinicians to recognize cytokine storm syndrome in the setting of COVID-19 for early initiation of potentially life-saving immunotherapy."

Members of the Intermountain research team: Webb, Ithan Peltan, Paul Jensen, Daanish Hoda, Bradley Hunter, Aaron Silver, Nathan Starr, Whitney Buckel, Nancy Grisel, Erika Hummel, Gregory Snow, Dave Morris, Eddie Stenehjem, Raj Srivastava, and Samuel M. Brown.

Intermountain Healthcare is a not-for-profit system of hospitals and clinics, a Medical Group, health insurance, and other health services in Idaho, Utah, and Nevada. Intermountain is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs.

Source: GlobalData.com