Within the constantly shifting parameters of the SARS-CoV-2 pandemic, certain biomarkers may provide valuable information that can aid in the management of patients in the hospital setting. For example, Roche recently received Emergency Use Authorization for the Elecsys® IL-6, an in-vitro diagnostic assay that can be used to assist in identifying severe inflammatory response in patients with confirmed COVID-19 illness.
By simple definition, a biomarker is a natural substance found in the body that serves as an indicator of a biological state, condition or disease. When compared to a baseline measurement, biomarker testing can reveal whether levels meet or exceed the limits for normal functions and processes. In turn, clinicians and healthcare providers can use this information to make the most appropriate decisions for their patients. It’s important to note that biomarkers are not a stand-alone factor in determining patient treatment, but may be used in conjunction with clinical assessments, imaging and medical evaluation.
While many people infected with COVID-19 will experience only mild to moderate symptoms that can be managed at home, or even no symptoms at all, biomarker-informed data may help clinicians determine prognoses and outcomes for patients who become critically ill from the virus, particularly older adults and those with underlying health conditions.
Each biomarker represents a unique biological response or function. To illustrate, measuring inflammatory response and testing for co-infections can provide insight as to the expected progression of the COVID-19 illness while also providing predictive data as to severity and mortality.
Among critically ill patient populations, mechanical ventilators may be employed to supply temporary respiratory support. Testing specific biomarkers when making decisions about mechanical ventilation can help doctors estimate the potential effectiveness of the treatment, and help to guide allocation of ventilators and other limited hospital resources. Biomarker testing may also play a role in the de-escalation of antimicrobial therapies in ventilated patients.
An increasing amount of evidence suggests that a coagulation biomarker may be associated with a heightened need for critical care support. In addition, the measurement of some biomarkers may be helpful in monitoring patients after COVID-19 recovery, although more research is needed in this area.
Although COVID-19 is predominantly considered a respiratory illness, studies have shown significant impact to multiple organs including the heart, liver and kidneys. COVID-19 can also present with systemic responses through coagulopathy and hyperinflammation, further illustrating that COVID-19 can manifest with multi-organ involvement.
While biomarker testing is not the only diagnostic tool to be relied upon in severe cases of COVID-19, it may provide crucial data and insight that can help to guide management of critically ill patients and to monitor disease progression and its impact on various organs.