Elevated Interleukin (IL)-6 as a Predictor of Disease Severity among Covid-19 Patients: a prospective cohort study

Abstract

Background accompanied to the spreading of coronavirus disease 2019 (Covid-19) in the world, identifying factors related to the severity of the disease is one of the interests of physician and medical researchers. We hypothesized that interleukin 6 serum level is associated with severe outcome. Methods In this longitudinal prospective cohort study we enrolled 208 confirmed COVID-19 patients who were admitted to the Tohid Hospital (Sanandaj, Iran). Patients were classified into two groups based on IL-6 value in the first day of admission, elevated (n = 107) or not elevated/normal (n = 101), and followed until the occurrence of final outcome (death or discharge from the hospital). Data were analyzed using univariate methods, Chi-squared and independent two sample T test. The relationship between the independent variables and our interesting outcomes were investigated by multiple linear and logistic regression modeling. Results A total of 208 patients, 51% female and mean age 53.6 ± 16.3 years, including 107 elevated and 101 non-elevated IL-6 patients, were followed. No significant difference was observed between the two groups in demographic and clinical characteristics. Although not significant, logistic regression results showed that the chance of death occurrence among patients with elevated IL-6 are 3.91 times higher. According to the multiple linear regression modeling, elevated IL-6 significantly increased the duration of hospital stay (P = 0.008). Frequency of ICU admission (P = 0.04) and mean of ICU stay (P = 0.8) are also higher in elevated IL-6 group. Conclusion This study revealed that elevated IL-6 is significantly related to prolongation of hospital stay in Covid-19 patients. Although not significant, the occurrence of death among patients who had increased IL-6 in the time of admission was higher than patients with normal or lower serum levels of IL-6.

Angiotensin-Converting Enzyme-2 (ACE-2) with Interferon-Induced Transmembrane Protein-3 (IFITM-3) Genetic Variants and Interleukin-6 as Severity and Risk Predictors among COVID-19 Egyptian Population

“…Furthermore, IL-6 levels were found to be substantially related to various clinical and laboratory indicators predicting a systemic infammatory response, such as CRP, ferritin, D-dimer, and LDH (Table S3). Te same correlation was reported by other studies; however, IL-6 seemed to be the major prognostic efector [24,47].…”

“…COVID-19 susceptibility and severity among studied cases were linked to age and associated comorbidities. Nikkhoo et al documented the same fnding [24,25].…”

Utility of nasal swabs for assessing mucosal immune responses towards SARS-CoV-2

“…Cytokine levels are commonly assessed in the blood to determine systemic levels of inflammation. Prior studies, including one from this cohort 14 , have shown elevated systemic levels of specific cytokines, including IL-1Ra and IL-8, have been previously associated with an increased risk of severe disease and poor outcomes in persons with SARS-CoV-2 infection [15][16][17][18] . However, little is known about the mucosal immune response to SARS-CoV-2 infection and whether the mucosal immune responses correlate with systemic immune responses, especially at later time points.…”

Prognostic value of interleukin‐6 serum levels in hospitalized COVID‐19 patients: A case—control study in Iran

“…Cytokine storm, the uncontrolled release of proinflammatory mediators are major risk factors for COVID‐19 severity. Among the cytokines, interleukin 6 (IL‐6) is one of the key cytokines 9,10 and there are some evidence that blood IL‐6 level is positively correlated to disease severity in COVID‐19 patients with severe complications 11,12 . To guide the local health authorities and predict the future severity of the disease, the primary objective of this study was firstly to measure the levels of IL‐6 in case and control groups as well as in relation to demographic factors, and secondly to determine the relationship between IL‐6 levels with the percentage of lung involvement.…”