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. 2020 Dec:128:64-68.
doi: 10.1016/j.molimm.2020.10.006. Epub 2020 Oct 14.

High serum IL-6 values increase the risk of mortality and the severity of pneumonia in patients diagnosed with COVID-19

Jose J Guirao  1 , Carmen M Cabrera  2 , Natalia Jiménez  1 , Laura Rincón  3 , José M Urra  4
Affiliations

High serum IL-6 values increase the risk of mortality and the severity of pneumonia in patients diagnosed with COVID-19

Jose J Guirao et al. Mol Immunol. 2020 Dec.

Abstract

The clinical presentation of COVID-19 is very heterogeneous, ranging from asymptomatic to severe, which could lead to the need for mechanical ventilation or even death.We analyzed the serum levels of IL-6 in patients with COVID-19 diagnosis and its relationship with the severity of the disease, the need for mechanical ventilation and with patient mortality. We assessed IL-6 in a cohort of 50 patients diagnosed with COVID-19 pneumonia with different degrees of disease severity, and compared it with clinical and laboratory findings. We found higher levels of IL-6 in patients with more severe pneumonia according to CURB-65 scale (p = 0.001), with ICU mechanical ventilation requirements (p = 0.02), and who subsequently died (p = 0.003). Of the clinical and analytical parameters analyzed in the current study, the serum levels of IL-6 was the most effective predictor of disease severity. From the data obtained in ROC curve analysis, we defined a cut-off point for serum IL-6 levels of 35 pg/mL above which both the risk of mortality (OR = 20.00, 95 % CI 4.214-94-912, p = 0.0001) and ICU admission (OR = 12.750, 95 % CI 2,159-75,3,3, p = 0.005) were increased. Starting from blood IL-6 levels 27 out of 50 patients, with high levels and more severe symptoms, were treated with the IL-6 receptor antagonist Tocilizumab. IL-6 serum levels appear to be a useful prognostic biomarker in patients with a diagnosis of COVID-19 pneumonia. A cut-off point of 35 pg/mL could clearly differentiate patients a with more severe disease.

Keywords: COVID-19 pneumonia; CURB-65 score; ICU admission; IL-6 serum levels; Mortality; Prognostic biomarkers.

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Conflict of interest statement

The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Mean in pg/mL of IL-6 serum levels according to disease severity (A), ICU admission (B), and mortality (C).
Fig. 2
Fig. 2
Percentage of patients with IL-6 serum values above 35 pg/mL depending on the pneumonia severity CURB-65 score (A), ICU admission (B) and mortality (C).
See this image and copyright information in PMC

References

    1. Campochiaro C., Della-Torre E., Cavalli G., De Luca G., Ripa M., Boffini N., Tomelleri A., Baldissera E., Rovere-Querini P., Ruggeri A., Monti G., De Cobelli F., Zangrillo A., Tresoldi M., Castagna A., Dagna L. Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study. Eur. J. Intern. Med. 2020;76:43–49. doi: 10.1016/j.ejim.2020.05.021. - DOI - PMC - PubMed
    1. Chen G., Wu D., Guo W., Cao Y., Huang D., Wang H., Wang T., Zhang Xiaoyun, Chen H., Yu H., Zhang Xiaoping, Zhang M., Wu S., Song J., Chen T., Han M., Li S., Luo X., Zhao J., Ning Q. Clinical and immunological features of severe and moderate coronavirus disease 2019. J. Clin. Invest. 2020;130:2620–2629. https://doi.org/10.1172%2FJCI137244. - PMC - PubMed
    1. Docherty A.B., Harrison E.M., Green C.A., Hardwick H.E., Pius R., Norman L., Holden K.A., Read J.M., Dondelinger F., Carson G., Merson L., Lee J., Plotkin D., Sigfrid L., Halpin S., Jackson C., Gamble C., Horby P.W., Nguyen-Van-Tam J.S., Ho A., Russell C.D., Dunning J., Openshaw P.J., Baillie J.K., Semple M.G. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369 doi: 10.1136/bmj.m1985. - DOI - PMC - PubMed
    1. Fadini G.P., Morieri M.L., Longato E., Avogaro A. Prevalence and impact of diabetes among people infected with SARS-CoV-2. J. Endocrinol. Invest. 2020:1–3. https://doi.org/10.1007%2Fs40618-020-01236-2. - PMC - PubMed
    1. George P.M., Wells A.U., Jenkins R.G. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir. Med. 2020;8:807–815. doi: 10.1016/S2213-2600(20)30225-3. - DOI - PMC - PubMed

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