HAEMATOLOGY
While initially a respiratory disease, COVID-19 is increasingly recognised as a systemic infection.
viscosity could be a particularly useful way of measuring this as it is known to show a significant increase in a range of different types of infection, including viral and bacterial.
Early identification of severely- affected patients
Benson Viscometers is currently exploring the possibility with partner laboratories of early identification of COVID-19 patients who subsequently go on to develop severe symptoms. This is important because early intervention could increase the likelihood of early recovery.
Daniel Gleghorn, a senior biomedical scientist at Cambridge University Hospitals NHS Foundation Trust, says: “We are interested in establishing the diagnostic and hopefully prognostic value of measuring the plasma viscosity of patients suspected or confirmed as having COVID-19. We are looking at determining a cut-off level for those patients who are positive and additionally following several patients’ progress through the condition, regularly monitoring their PV level.”
A symptomatic or confirmed person with COVID-19 will probably have an increased PV above the normal range. The patient’s result is likely to continue rising if their condition deteriorates, until their immune response successfully has the infection under control. A rising daily PV may indicate that a COVID-19 patient is developing severe symptoms and requires more intensive therapy, such as oxygen support in the form of CPAP or IPPV (ventilation). Similarly, a fall
or plateau in PV could be indicative that a patient is over the worst of the infection and that they therefore require a less-intrusive approach.
Identification of recovered patients While the patient is in recovery, the PV result is likely to begin to fall. However, paradoxically, most patients are likely still to have a positive antigen test. It is proposed that the start of the reduction in viscosity, when measured on consecutive days,
could be used as an indicative marker of patient recovery. Hence the patient and their relatives could be informed potentially earlier than at present that there is an indication of recovery, thus reducing anxiety for clinicians and families. If a daily PV monitoring routine is started as early as practical, a record of the disease’s progress will be available to aid clinicians in determining the most appropriate treatment. With data analysis and experience, they will then be able to forecast and prepare for a worsening condition if the data show a patient’s condition is deteriorating.
Plasma therapy
The use of plasma therapy on COVID-19 patients is also an area of significant interest. This experimental therapy involves transfusing the antibody-rich blood plasma of recovered COVID-19 patients into people who are fighting the illness. A recent study, co-authored by researchers at several institutions including Michigan State University, has shown that the treatment is safe. Plasma viscosity measurement could be an important next step in establishing its effectiveness.
The Benson BV1 viscometer. 62 l
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As one of the parameters that raises the PV result is the concentration of antibodies in a person’s plasma, patients who have recovered from the virus but maintain a raised viscosity result may have a high-titre antibody level, which would suggest they could be suitable donors for plasmapheresis to provide antibody therapy protection to other patients.
OCTOBER 2020
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