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Meta-Analysis
. 2020 Oct;72(8):431-437.
doi: 10.1007/s00251-020-01179-1. Epub 2020 Oct 17.

Elevated interleukin-6 and adverse outcomes in COVID-19 patients: a meta-analysis based on adjusted effect estimates

Peihua Zhang  1 , Li Shi  1 , Jie Xu  1 , Yadong Wang  2 , Haiyan Yang  3
Affiliations
Meta-Analysis

Elevated interleukin-6 and adverse outcomes in COVID-19 patients: a meta-analysis based on adjusted effect estimates

Peihua Zhang et al. Immunogenetics. 2020 Oct.

Abstract

This study aimed to evaluate the association of interleukin-6 (IL-6) level with the poor outcomes in coronavirus disease 2019 (COVID-19) patients by utilizing a meta-analysis based on adjusted effect estimates. We searched the keywords from PubMed, Web of Science, and EMBASE on August 14, 2020. The pooled effects and 95% confidence interval (95% CI) were estimated by Stata 11.2. Subgroup analysis and meta-regression were performed to explore the source of heterogeneity. Sensitivity analysis was implemented to assess the stability of the results. Begg's test and Egger's test were conducted to assess the publication bias. Sixteen articles with 8752 COVID-19 patients were finally included in the meta-analysis. The results based on random-effects model indicated that elevated value of IL-6 was significantly associated with adverse outcomes in patients with COVID-19 (pooled effect = 1.21, 95% CI 1.13-1.31, I2 = 90.7%). Subgroup analysis stratified by disease outcomes showed consistent results (severe: pooled effect = 1.18, 95% CI 1.05-1.31; ICU (intensive care unit) admission: pooled effect = 1.90, 95% CI 1.04-3.47; death: pooled effect = 3.57, 95% CI 2.10-6.07). Meta-regression indicated that study design was a source of heterogeneity. Publication bias was existent in our analysis (Begg's test: P = 0.007; Egger's test: P < 0.001). In conclusion, the elevated IL-6 level is an independent risk factor associated with adverse outcomes in patients with COVID-19.

Keywords: Adjusted effect estimates; Adverse outcomes; COVID-19; IL-6; Meta-analysis.

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Figures

Fig. 1
Fig. 1
Forest plot with pooled effects and 95% confidence interval (CI) indicating the association between interleukin-6 (IL-6) level and adverse outcomes in coronavirus disease 2019 patients (a). Subgroup analysis based on different disease outcomes (severe (b), ICU (intensive care unit) admission (c), death (d)). Sensitivity analysis (e).
See this image and copyright information in PMC

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