Diagnosing the onset of severe Covid-19 disease

A recent report from China has indicated that many or most individuals who die from severe Covid-19 infections have sepsis. Sepsis is broadly defined as an abnormal host response to infection that causes life-threatening organ dysfunction, and was responsible for 19.7% of global deaths in 2017. Sepsis is a very complex disease, consisting of phenotypic clusters of patients, that constitute distinct endotypes, which are biologically driven and relevant to clinical outcomes. We have defined 5 sepsis endotypes in a large clinical study and propose to extend this here to severely ill Covid-19 patients. We will collect blood from up to 200 patients in BC and Quebec, and analyze the genes that are expressed in these cells (which will enable us to discriminate endotypes). This will allow us to define a set of genes for which the levels of expression correlate with future disease severity. This information will allow the development of a diagnostic that will enable a physician to predict the likely severity of a patient's disease and apply knowledge-driven clinical management. Furthermore, since endotypes operate under distinct mechanisms this knowledge will enable the discovery, by others, of targeted therapies to treat Covid-19 associated sepsis.