Emerging Tests

Simple Urine Test May Be Capable of Predicting COVID-19 Case Severity

Analyzing a COVID-19 patient’s urine sample can help treatment providers predict how severe the case will be. That is the finding of a new study created by researchers from Detroit-based Wayne State University. Such an assay would be a useful tool for screening hospital patients and preserving treatment resources.

The Diagnostic Challenge

COVID-19 affects different people different ways. Some people experience no symptoms at all. But others may experience pneumonia with multiple organ failure, and death. Early identification of critical patients requiring more aggressive intervention could prove instrumental in reducing COVID-19 deaths.

One of the most promising leads in that regard is the recognition that in many severe COVID-19 cases, patients produce cytokine proteins at elevated levels. These so-called “cytokine storms” cause inflammation in multiple organs, including the heart, lungs and brain. Accordingly, urine tests that measure cytokine levels may be effective in predicting case severity. Such tests are currently used for screening urinary tract infections, interstitial cystitis and other illnesses.

The Wayne State Study

With this in mind, the Wayne State research team set out to determine whether COVID-19 biomarkers were capable of predicting which individuals will develop cytokine storms. The study compared urine cytokine levels in 17 patients with confirmed COVID-19 cases and 10 patients without the infection.

The study results, which were first revealed during the annual meeting of the American Physiological Society, found that the cytokine levels of patients who had the virus were “significantly elevated,” specifically:

  • Growth-regulated oncogene; and
  • Interleukin-6 (IL-6).

The most highly elevated urinary cytokine levels were found in patients with pre-existing chronic health conditions such as high blood pressure and diabetes. People with these health conditions are considered to be at higher risk of severe illness from COVID-19, the researchers concluded.

In addition, the researchers found that in all cases, cytokine levels retreated to normal ranges once the infection resolves.

“We have observed, albeit in a small cohort of patients that we examined, that the urinary cytokine levels increase as the infection progresses, and that they decrease as the infection resolves,” study co-author and Wayne State assistant professor of research Dragana Komnenov told a UPI reporter in an email. “This suggests that the urinary cytokine signature could potentially have diagnostic and-or prognostic value.”

Takeaway

The pandemic is winding down but people are still dying from the SARS-CoV-2 virus. This dynamic is likely to accelerate efforts to develop COVID-19 diagnostics not simply to detect infections but also generate results to support treatment decisions. The hope is that the Wayne State study will translate into a regular process for severity screening of COVID-patients.

 Another promising effort in this direction is a study from scientists at the University Medical Center Goettingen in Germany finding that leukocytes and albumin in urine may also be a reliable biomarker for use in predicting the severity of COVID-19 infection.

 

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