Clinical Decision Support Tool and Rapid Point-of-Care Platform for Determining Disease Severity in Patients with COVID-19

Michael P McRae; Glennon W Simmons; Nicolaos J Christodoulides; Zhibing Lu; Stella K Kang; David Fenyo; Timothy Alcorn; Isaac P Dapkins; Iman Sharif; Deniz Vurmaz; Sayli S Modak; Kritika Srinivasan; Shruti Warhadpande; Ravi Shrivastav; John T McDevitt

The sooner these patients are identified, the better is their prognosis through stabilizing measures and close monitoring. As highlighted in the Introduction, one of the major diagnostic gaps and the focus of this paper is determining COVID-19 disease severity, which is the third relevant diagnostic test associated with COVID-19. Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections. 8 A report from the Chinese Center for Disease Control and Prevention stated that the case fatality rate was higher for those with cardiovascular disease (10.5%), diabetes (7.3%), chronic respiratory disease (6.3%), hypertension (6.0%), and cancer (5.6%). Growing evidence suggests that COVID-19 interacts with the cardiovascular system on multiple levels with increased morbidity and mortality in those with underlying cardiovascular conditions. 31 Further, evidence of myocardial injury has been observed at higher rates in those that died. 31 In a study of 187 patients, 7.6% of patients (8 of 105) with normal cardiac troponin T levels and without cardiovascular disease died versus 69.4% of patients (25 of 36) with both elevated cTnT and cardiovascular disease. 14 The underlying health of the patient has a strong association with COVID-19 outcomes and must be included in clinical decision support tools for determining disease severity.