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. 2024 Dec 9;14(12):e085971.
doi: 10.1136/bmjopen-2024-085971.

Predictive validity of interleukin 6 (IL-6) for the mortality in critically ill COVID-19 patients with the B.1.617.2 (Delta) variant in Vietnam: a single-centre, cross-sectional study

Chi Van Nguyen  1   2 , Chinh Quoc Luong  1   2   3 , Co Xuan Dao  2   3   4 , My Ha Nguyen  5 , Dung Thi Pham  6 , Nhung Hong Khuat  2   7 , Quynh Thi Pham  2   8 , Dat Tien Hoang  2   4 , Anh Diep Nguyen  2   9 , Phuong Minh Nguyen  2   10 , Duong Dai Cao  2   11 , Dung Thuy Pham  2   12 , Thai Quoc Nguyen  13 , Vuong Minh Nong  13 , Dung Tuan Dang  1   3 , Dat Tuan Nguyen  1   2   3 , Vinh Duc Nguyen  1 , Thuan Quang Le  2   14 , Viet Khoi Nguyen  15   16 , Hung Duc Ngo  1   2 , Dung Van Nguyen  13 , Thach The Pham  2   3   4 , Dung Tien Nguyen  2   14 , Nguyen Trung Nguyen  2   3   14 , Tan Dang Do  15 , Nhung Thi Huynh  17 , Nga Thu Phan  5 , Cuong Duy Nguyen  18 , Khoi Hong Vo  19   20   21 , Thom Thi Vu  22 , Cuong Duy Do  13   23 , Tuan Quoc Dang  2   4 , Giap Van Vu  24   25 , Tan Cong Nguyen  26   3   4 , Son Ngoc Do  2   3   4
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Predictive validity of interleukin 6 (IL-6) for the mortality in critically ill COVID-19 patients with the B.1.617.2 (Delta) variant in Vietnam: a single-centre, cross-sectional study

Chi Van Nguyen et al. BMJ Open. .

Abstract

Objectives: To investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam.

Design: A single-centre, cross-sectional study.

Setting: An Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam.

Participants: We included patients aged 18 years or older who were critically ill with COVID-19 and presented to the study centre from 30 July 2021 to 15 October 2021. We excluded patients who did not have serum IL-6 measurements between admission and the end of the first day.

Primary outcome measures: The primary outcome was hospital all-cause mortality.

Results: Of 90 patients, 41.1% were men, the median age was 60.5 years (Q1-Q3: 52.0-71.0), and 76.7% of patients died in the hospital. Elevated IL-6 levels were observed on admission (41.79 pg/mL; Q1-Q3: 20.68-106.27) and on the third day after admission (72.00 pg/mL; Q1-Q3: 26.98-186.50), along with a significant rate of change in IL-6 during that period (839.5%; SD: 2753.2). While admission IL-6 level (areas under the receiver operator characteristic curve (AUROC): 0.610 (95% CI: 0.459 to 0.761); cut-off value ≥15.8 pg/mL) and rate of change in IL-6 on the third day of admission (AUROC: 0.586 (95% CI: 0.420 to 0.751); cut-off value ≥-58.7%) demonstrated poor discriminatory ability in predicting hospital mortality, the third day IL-6 rate of change from admission ≥-58.7% (adjusted OR: 12.812; 95% CI: 2.104 to 78.005) emerged as an independent predictor of hospital mortality.

Conclusions: This study focused on a highly selected cohort of critically ill COVID-19 patients with a high IL-6 level and mortality rate. Despite the poor discriminatory value of admission IL-6 levels, the rate of change in IL-6 proved valuable in predicting mortality. To identify critically ill COVID-19 patients with the highest risk for mortality, monitoring the serial serum IL-6 measurements and observing the rate of change in serum IL-6 levels over time are needed.

Keywords: ACCIDENT & EMERGENCY MEDICINE; Adult intensive & critical care; COVID-19; Mortality; SARS-CoV-2 Infection.

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Conflict of interest statement

Competing interests: None declared.

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