Can We Predict the Severity of COVID-19? Maybe. 

Throughout the COVID-19 pandemic, researchers have tried to identify early indications of disease severity in patients at higher risk for complications, such as people with obesity or people over the age of 65. Recent studies by Yale show promising results that saliva tests and blood tests may allow doctors to predict how severe patient symptoms will be on a case-by-case basis. 


While similar in outcome, the studies each took largely different approaches to the topic: one study examined the accuracy of a saliva test while the other examined blood testing. This begs two questions: what is the difference between the two tests, and will either provide accurate predictions? 


Predicting COVID-19 Severity Using Saliva 


While simpler in use than the standard nasal-swab currently performed in COVID-19 testing, the saliva collection technique is only available today at select laboratories. Saliva COVID-19 testing is not currently available to most people, but researchers have become increasingly interested in the potential of the saliva testing method. 


Research on the saliva test shows that patients with increased SARS-CoV-2 viral load could be more susceptible to disease complications. Unlike the nasal-swab testing method, the saliva test can provide information on the condition of a patient’s lungs. Mucus regularly travels via cilia (hair like structures) from the lungs to the throat where it combines with saliva; if the virus is found in saliva, it is possible that the virus has entered the lungs — where COVID-19 complications are typically most severe. 


According to the preliminary results of the study, saliva viral load directly relates to disease severity, as well as other parameters tested by Yale. These include obesity, age, immune response and more. 


Blood Testing Evaluates Biomarkers


Much like the saliva-based study, the blood test study aimed to find early predictors in patients who later developed severe COVID-19 complications. Researchers found that certain biomarkers associated with white blood cell activation were potential early complication indicators. 


While blood samples were only taken from 100 patients, a clear pattern in results emerged. Those who later experienced critical illness in relation to COVID-19 showed increased levels of five proteins related to neutrophils, a type of inflamed white blood cell. Those who did not experience symptoms or complications did not show the increased protein levels or neutrophil biomarkers. 


Results from this study note that neutrophils are increased in both cases of COVID-19 and obesity. These biomarkers appeared in COVID-19 patients before they began to experience symptoms and were not previously associated with COVID-19.  While neutrophils are common in infections and other causes of inflammation (such as obesity), understanding the link between neutrophils and COVID-19 can help doctors better predict severity and treat patients accordingly.


The Bottom Line


Both studies have provided insights in the hunt for new information about early indication of COVID-19 complications. While each study requires expanded research before public use and implementation, both collaboratively provide a glimmer of hope for COVID-19 treatment and preparedness. 


Sources: Yale Medicine, Yale School of Medicine

A Guide to Common Cancer Treatments: Therapies and Surgery

There are many cancer treatments available to patients, with new cancer treatments in clinical trials every day. Cancer treatment typically depends on the type of cancer, and certain treatments are only applicable to cancers with certain “markers.” While this may seem confusing, the vast majority of cancer treatments fit into a few categories, namely immunotherapy, chemotherapy (both classical and molecularly defined), radiation therapy, hormonal therapy and surgery. Here’s a breakdown of the different cancer treatments and what you need to know.


The body’s natural immune system works to eliminate abnormal cells in the body, but some cancers are particularly adept at avoiding immune responses. Tumors can have proteins that allow them to evade detection by the immune system or can alter the cells around them to interfere with the immune response. Immunotherapy works to boost the body’s natural immune response to cancer, often by enhancing the overall immune system or reducing the natural “checkpoints” that the immune system utilizes to prevent dangerous immune responses. Some forms of immunotherapy also involve creating specific cancer antibodies in a lab to educate and bolster the immune system. 

Immunotherapy is being used effectively for a wide range of cancers but is still relatively new compared to traditional cancer treatments like chemotherapy and radiation therapy. However, immunotherapy holds great potential for personalized, effective cancer treatment and is the largest area of growth today for cancer treatment.

Chemotherapy  (Classical and Molecularly Targeted)

Chemotherapy is an effective cancer treatment that uses medication to kill or reduce cancer cells. Many people are familiar with chemotherapy, because it has been a first-line cancer treatment for decades. Chemotherapy can completely eliminate cancer cells and may be the only treatment that a cancer patient receives, or chemotherapy can be used to reduce the size of a tumor to increase the odds of a successful surgical removal. For advanced cancers with no other treatment options, chemotherapy can also be used to temporarily relieve symptoms and increase life expectancy.

While classical chemotherapy can be a life-saving cancer treatment, it often comes with some unpleasant side effects. Chemotherapy affects the way that cancer cells divide and multiply, but it can also impact healthy cells in the process. For this reason, patients may experience nausea, hair loss or fatigue, which can make it necessary to alter daily routines or work schedules. Nevertheless, chemotherapy is still the gold standard of treatment for many forms of cancer because of its favorable outcomes.  More recently, many forms of molecularly targeted therapies have been discovered and approved.  They are much more specific than the traditional chemotherapies and target the actual control mechanisms that regulate the growth, proliferation and spread of cancer cells.  This represents an area of cancer treatment with virtually limitless options as we learn more and more about the genes that regulate cancer in children and adults.  

Radiation Therapy

Radiation therapy works to kill cancer cells and shrink tumors with high amounts of radiation. The goal of radiation therapy is to damage the DNA of cancer cells to the point that the cancer cells can no longer divide and ultimately die, prompting the body to remove them. While radiation therapy can be an effective cancer treatment in certain cancers, it takes time and repeated radiation sessions to yield the necessary damage to cancer cells. Then, it takes months for all of the cells to die and for the body to completely remove the dead cells.

The primary drawbacks to radiation therapy are the side effects and the safety limits for lifetime exposure to radiation. Radiation therapy can affect both the cancer cells and nearby healthy cells, causing a lot of internal damage. Depending on where the radiation therapy is administered, you can have a wide range of side effects from headaches to fertility problems. Regardless of where your cancer is located, it is very likely that you will experience fatigue as your body works to repair the damage.

Luckily, side effects usually fade away in the months that follow radiation therapy, and radiation therapy can cure or shrink your cancer significantly.


During surgical cancer treatment, a surgeon removes a tumor or cancer cells from your body. Surgery can be very effective for local cancers and can even eliminate your cancer without additional treatment. Surgeons can also use different devices, like lasers, to kill abnormal cells. Surgical treatment works best for localized cancer and is not effective for blood-borne cancers, such as lymphoma or leukemia, or cancers that have metastasized (spread) to other locations in the body.

Often, surgery is used in combination with chemotherapy or radiation therapy. Surgery may be done first to remove the primary tumor and followed by chemotherapy or radiation to kill additional cancer cells. Or, surgery may be done after chemotherapy or radiation therapy has reduced the size of a tumor.

For local cancers, surgery can be a very effective treatment with few side effects. Catching cancer in its early stages can reduce the chances that the cancer has metastasized and increase the efficacy of surgery and overall survival.

Hormone Therapy

For specific types of cancer that are reliant on hormones to grow, hormone therapy can be a treatment option. Certain types of breast cancer and prostate cancer fall into this category and can be treated with hormonal medications. Medications that block hormones do not cause the same destruction to healthy cells as radiation therapy and chemotherapy, but the impact on hormones is likely to cause temporary hormonal imbalances and corresponding side effects, such as hot flashes and changes to libido.

Genetic Testing and New Advances

With increased genetic testing and other medical advances, new cancer treatments are being tested every day. Some promising cancer treatments include the molecularly targeted therapies briefly mentioned earlier, which attack the specific changes in cancer cells that allow them to multiply and genetic therapies for cancer, including precision medicine and biomarker testing. Understanding the specific genetic qualities of different cancers can help doctors provide the most effective and precise treatment with as few side effects and as little impact to healthy cells as possible. 

Source: NIH