An immune-protein score combining TRAIL, IP-10 and CRP for predicting severe COVID-19 disease

Niv Samuel Mastboim, Alon Angel, Oded Shaham, Tahel Ilan Ber, Roy Navon, Einav Simon, Michal Rosenberg, Yael Israeli, Mary Hainrichson, Noa Avni, Eran Reiner, Paul Feigin, Kfir Oved, Boaz Tadmor, Pierre Singer, Ilya Kagan, Shaul Lev, Dror Diker, Amir Jarjou'I, Ramzi KurdEli Ben-Chetrit, Guy Danziger, Sina A. Tegethoff, Cihan Papan, Sergey Motov, Ma'anit Shapira, Michal Stein, Tanya M. Gottlieb*, Eran Eden, Adi Klein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


COVID-19 patients are oftentimes over- or under-treated due to a deficit in predictive management tools. This study reports derivation of an algorithm that integrates the host levels of TRAIL, IP-10, and CRP into a single numeric score that is an early indicator of severe outcome for COVID-19 patients and can identify patients at-risk to deteriorate. 394 COVID-19 patients were eligible; 29% meeting a severe outcome (intensive care unit admission/non-invasive or invasive ventilation/death). The score's area under the receiver operating characteristic curve (AUC) was 0.86, superior to IL-6 (AUC 0.77; p = 0.033) and CRP (AUC 0.78; p < 0.001). Likelihood of severe outcome increased significantly (p < 0.001) with higher scores. The score differentiated severe patients who further deteriorated from those who improved (p = 0.004) and projected 14-day survival probabilities (p < 0.001). The score accurately predicted COVID-19 patients at-risk for severe outcome, and therefore has potential to facilitate timely care escalation and de-escalation and appropriate resource allocation.

Original languageEnglish
Article number156246
StatePublished - Sep 2023


FundersFunder number
Einat Moscoviz
European Commission, Executive Agency for Small and Medium-sized Enterprises H2020-EIC-SMEInst-2018-2020-288124


    • COVID-19 disease severity prediction
    • Emergency Department
    • Host-immune protein score
    • SARS-CoV-2


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