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. 2022 Oct 24;10(11):1786.
doi: 10.3390/vaccines10111786.

Utility of IL-6 in the Diagnosis, Treatment and Prognosis of COVID-19 Patients: A Longitudinal Study

Vikram Jain  1 , Pratap Kumar  1 , Prasan Kumar Panda  1 , Mohan Suresh  1 , Karanvir Kaushal  2 , Anissa A Mirza  2 , Rohit Raina  1 , Sarama Saha  2 , Balram J Omar  3 , Vivekanandhan Subbiah  2
Affiliations

Utility of IL-6 in the Diagnosis, Treatment and Prognosis of COVID-19 Patients: A Longitudinal Study

Vikram Jain et al. Vaccines (Basel). .

Abstract

COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of COVID-19-related cytokine storm. Patients with COVID-19 who were admitted at AIIMS Rishikesh from March to December 2020 were included in the study. Patients with no baseline IL-6 value at admission and for whom clinical data were not available were excluded. Clinical and laboratory data of these patients were collected from the e-hospital portal and entered in an excel sheet. Correlation was seen with other inflammatory markers and outcomes were assessed using MS Excel 2010 and SPSS software. A total of 131 patients were included in the study. Of these, 74.8% were males, with mean age 55.03 ± 13.57 years, and mean duration from symptom onset being 6.69 ± 6.3 days. A total of 82.4% had WHO severe category COVID-19, with 46.56% having severe hypoxia at presentation and 61.8% of them having some comorbidity. Spearman rank correlation coefficient of IL-6 with D-dimer was 0.203, with LDH was -0.005, with ferritin was 0.3, and with uric acid was 0.123. A total of 11 patients received Tocilizumab at a mean duration from symptom onset of 18.09 days, and 100% mortality was observed. Deaths were reported more in the group with IL-6 ≥ 40 pg/mL (57.1% vs. 40.2%, p = 0.06). ICU admissions and ventilator requirement were higher in the IL-6 ≥ 40 pg/mL group (95.9% vs. 91.4%, p = 0.32 and 55.1% vs. 37.8%, p = 0.05). The study showed that IL-6 can be used as a possible "thrombotic cytokine marker". Higher values of IL-6 (≥40 pg/mL) are associated with more deaths, ICU admissions, and ventilator requirement.

Keywords: D-dimer; LDH; SARS-CoV-2; coronavirus; cytokine storm; ferritin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow of study.
Figure 2
Figure 2
Scatterplots showing correlation of IL-6 with various inflammatory markers.
Figure 3
Figure 3
(A) Comparison of deaths between the groups. (B) Comparison of need for ICU stay between the groups. (C) Comparison of invasive mechanical ventilation (IMV) requirement between the groups.
Figure 3
Figure 3
(A) Comparison of deaths between the groups. (B) Comparison of need for ICU stay between the groups. (C) Comparison of invasive mechanical ventilation (IMV) requirement between the groups.
See this image and copyright information in PMC

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