426. Use of Real Time IP-10 Measurements to Identify and Monitor the Dysregulated Immune Response in COVID-19 Patients

Background: It is estimated that up to 10% of SARS-CoV-2 patients progress from early and pulmonary stages to the most severe stage of illness, which manifests as an extra-pulmonary systemic hyperinflammatory syndrome Interferon gamma-induced protein 10 (IP-10) is an inflammatory marker that plays a role in the dysregulated host response of COVID-19 infected patients Clinical monitoring of IP-10 has been restricted in the absence of a rapid diagnostic test MeMed KeyTM is a novel platform recently cleared to provide IP-10 measurements in 15 minutes We hypothesized that providing physicians with real time IP-10 measurements would support detection and continuous monitoring of patients with a dysregulated immune response and potentially allow personalized immunomodulation to improve patient outcome IP-10 levels reflect corticosteroid treatment Methods: From 7th April 2020 to 10th May 2020 blood was routinely collected serially from 52 SARS-CoV-2 positive patients hospitalized at a COVID-19 dedicated medical center A clinical decision support protocol was in place focused on managing viral response, oxygenation and inflammatory state (NCT04389645) Results: The median age of the 52 patients was 69, 69% were male, 21% were ventilated, 4 died, 2 due to non-COVID-19 related complications The most common comorbidities were Diabetes 40% and Hypertension 46% IP-10 >1000 pg/ml correlated with ICU admission (p1000 pg/ml, of these 12 were treated with corticosteroids Monitoring IP-10 within the clinical decision support protocol assisted with personalized corticosteroid regimens with the aim of reducing IP-10 1000 pg/ml for 2 6 days on average In contrast, the 2 patients that died of COVID-19 related complications displayed an average of 7 5 days with IP-10 >1000 pg/ml (p< 0 05) Conclusion: Providing physicians with real time measurements of IP-10 in COVID-19 patients proved a useful tool as part of the clinical decision support protocol Timely identification, monitoring and personalized treatment of COVID-19 patients exhibiting a dysregulated immune response may aid in improving patient outcome Further studies are warranted