Researchers at Washington University School of Medicine in St. Louis found that a relatively simple and rapid blood test can predict — within a day of a hospital admission — which patients with Covid-19 are at the highest risk of severe complications or death.

The study, published in the journal JCI Insight, involved nearly 100 patients newly admitted to the hospital with Covid-19.

The researchers vouched for the blood test that measures levels of mitochondrial DNA, a unique type of DNA molecule that normally resides inside the energy factories of cells.

“Doctors need better tools to evaluate the status of Covid-19 patients as early as possible because many of the treatments — such as monoclonal antibodies —are in short supply, and we know that some patients will get better without intensive treatments,” said co-senior author Andrew E Gelman, Ph.D., the Immunology and Oncology in the Department of Surgery.

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“Our study suggests that tissue damage may be one cause of this spiral since the mitochondrial DNA that is released is itself an inflammatory molecule,” he added.

The researchers said the test could serve as a way to predict disease severity as well as a tool to better design clinical trials.

“If we could determine in the first 24 hours of admission whether a patient is likely to need dialysis or intubation to keep their blood pressure from dropping too low, that would change how we triage the patient, and it might change how we manage them much earlier in the disease course,” said co-senior author Hrishikesh S Kulkarni, MD, an assistant professor of medicine.

For the study, the researchers evaluated 97 patients with Covid-19 at Barnes-Jewish Hospital, measuring their mitochondrial DNA levels on the first day of their hospital stays.

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They found that mitochondrial DNA levels were much higher in patients who eventually were admitted to the ICU, intubated, or died. The researchers found this association held independently of a patient's age, sex, and underlying health conditions.

On average, mitochondrial DNA levels were about tenfold higher in patients with Covid-19 who developed severe lung dysfunction or eventually died.

Those with elevated levels were almost six times more likely to be intubated, three times more likely to be admitted to the ICU, and almost twice as likely to die compared with those with lower levels.

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