COVID-19 is an unpredictable disease. As of May 2020, about ~4% of the infected had to be hospitalized. Of those, ~19% required intensive care and ~18% died. Our project aims to address the unpredictability faced by doctors and nurses when treating COVID-19 patients. We will develop a predictive blood test able to identify individuals at high risk for severe COVID-19 disease. Our test will guide clinical decision making, improve patient outcome and reduce costs, and may lead to a screening test to identify high-risk individuals in the general population.
We use information on how genes are regulated to develop our test. From influenza, we know that the genes of the immune system are switched on and off according to a specific pattern as the infection progresses. This pattern correlates well with the severity of the disease. A similar pattern can be seen for other viruses, including those causing the common cold. In this project, we will use knowledge about these patterns to make a blood test that can predict the outcome of COVID-19 for an individual.
We have gathered an ideal team for the job: the diagnostics startup Age Labs and the Norwegian Institute of Public Health (NIPH) have previously built blood-based prediction models for other diseases using this approach. The Dahl research group at Oslo University Hospital (OUH) specializes in gene regulation and lab methods required to measure it. The clinical groups at the Department of Acute Medicine at OUH Ullevål and Internal Medicine at Bærum Hospital are tasked with treating COVID-19 patients in need of hospitalization. Both hospitals will run a trial of our blood test in a real-life setting, as part of this project.
COVID-19 disease shows an unpredictable disease course with a wide range of complications. As of May 2020 the disease had a ~4% hospitalization rate. Of those hospitalized, ~19% required intensive care and ~18% died. Sepsis is another infectious disease that is often overlooked due to an unpredictable disease course. In Norway, this condition has an in-hospital mortality of ~24% and early diagnosis and treatment is essential. The PREDCOV project aims to address a clinical need related to this unpredictability: to better identify patients with COVID-19 and other infectious diseases at high risk for severe disease, complications and death, using a predictive blood test. The test will guide clinical decision making, improve patient outcome and reduce costs.
It is well-documented that the gene expression in immune system cells follows a certain temporal pattern when faced with different bacteria, influenza virus, rhinovirus and coronaviruses, and that expression of specific genes correlates well with the severity of disease. We will collect and analyze genome-wide data on the gene-regulation of white blood cells to predict the outcome of COVID-19 and other severe infectious diseases. The data will be collected from patients before, during, and after their infection.
Our project is uniquely positioned to perform the research quickly. Age Labs and the Norwegian Institute of Public Health have built and published blood-based prediction models from such data previously. The Dahl group at the Oslo University Hospital and Age Labs have collaborated to establish a prospective cohort study for COVID-19 patients in Norway, and we are already collecting the necessary blood samples. The Dept of Acute Medicine at Oslo University Hospital and Internal Medicine at Bærum Hospital treat patients with infectious diseases, including COVID-19 and sepsis. Both sites will run a trial study to evaluate the performance of the test in a representative hospital setting.