Study seeks risk factors for COVID-19 severity

Researchers at the University of Georgia College of Public Health are working to determine risk factors for severe cases of COVID-19.

The team, led by physician and epidemiologist Mark Ebell, is collecting information on patients suspected of having COVID-19, including a catalog of their symptoms and results from a common test used to determine levels of inflammation in the body.

The study is being done in partnership with the Whitefoord Clinic, a federally qualified health center in Atlanta that serves a population at higher risk for severe COVID-19 infections.

“Ultimately, we’d like to identify predictors of who is more likely to have a prolonged or serious course of COVID-19,” said Ebell.

This type of work is familiar to Ebell, who studies how to help clinicians make better and safer diagnostic decisions. In 2017, he published a set of clinical decision rules in the Annals of Family Medicine to help clinicians more accurately diagnose bacterial sinus infections that warrant antibiotic treatment thus curbing unnecessary antibiotic use.

Once clinic staff have identified suspected patients and drawn blood, two public health doctoral students, Cassie Hulme and Michelle Bentivegna, will be tracking how patients’ symptoms progress.

“They receive surveys for as long as they are symptomatic or up to 28 days,” said Bentivegna. “These surveys collect information on symptom severity as well as if the patient sought care again.”

In addition to documenting symptoms, the team is performing a C-reactive protein (CRP) test on patient blood samples to get a sense of their level of infection.

When a virus enters the body, the immune response sends in immune cells to attack the virus, resulting in inflammation. The greater the inflammation, the worse the infection.

“CRP is a general measure of inflammation,” said Ebell, “and patients with a heightened inflammatory response tend to do worse.”

There has been recent coverage on the severe impacts COVID-19 can have on some patients, due to an overreaction of the body’s immune system known as a cytokine storm. Cytokines coordinate the body’s response to infection, and in some patients, the novel coronavirus triggers cytokines to go into overdrive, which can be deadly.

“Basically, a cytokine storm is a very vigorous immune reaction that ends up damaging the body’s own cells,” said Ebell.

The outcome of this study could help providers get patients who might experience this type of severe reaction faster.

The team has already recruited 50 patients with plans to recruit 200 total participants. They anticipate having some initial results by June.

– Lauren Baggett

Read the story on UGA Today. Additional coverage at Athens Banner Herald and WGAU.

Posted on May 6, 2020.