Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19

BackgroundInterleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients...

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Main Authors: Zeming Liu (Author), Jinpeng Li (Author), Danyang Chen (Author), Rongfen Gao (Author), Wen Zeng (Author), Sichao Chen (Author), Yihui Huang (Author), Jianglong Huang (Author), Wei Long (Author), Man Li (Author), Liang Guo (Author), Xinghuan Wang (Author), Xiaohui Wu (Author)
Format: Book
Published: Frontiers Media S.A., 2020-07-01T00:00:00Z.
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Summary:BackgroundInterleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients have not been fully elucidated.ObjectiveTo validate whether IL-6 levels are associated with disease severity and mortality and to investigate whether dynamic changes in IL-6 levels might be a predictive factor for lung injury in COVID-19 patients.MethodsThis retrospective, single-center study included 728 adult COVID-19 patients and used data extracted from electronic medical records for analyses.ResultsThe mortality rate was higher in the elevated IL-6 group than in the normal IL-6 group (0.16 vs 5%). Cox proportional hazards and logistic regression analyses for survival (adjusted hazard ratio, 10.39; 95% confidence interval [CI], 1.09-99.23; p = 0.042) and disease severity (adjusted odds ratio, 3.56; 95% CI, 2.06-6.19; p < 0.001) revealed similar trends. Curve-fitting analyses indicated that patient computed tomography (CT) scores peaked on days 22 and 24. An initial decline in IL-6 levels on day 16 was followed by resurgence to a peak, nearly in tandem with the CT scores.ConclusionIncreased IL-6 level may be an independent risk factor for disease severity and in-hospital mortality and dynamic IL-6 changes may serve as a potential predictor for lung injury in Chinese COVID-19 patients. These findings may guide future treatment of COVID-19 patients.
Item Description:1663-9812
10.3389/fphar.2020.01093