Frontiers in Medicine (Jun 2022)

SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort

  • Emilia Roy-Vallejo,
  • Laura Cardeñoso,
  • Ana Triguero-Martínez,
  • Marta Chicot Llano,
  • Nelly Zurita,
  • Elena Ávalos,
  • Ana Barrios,
  • Julia Hernando,
  • Javier Ortiz,
  • Sebastián C. Rodríguez-García,
  • Marianela Ciudad Sañudo,
  • Celeste Marcos,
  • Elena García Castillo,
  • Leticia Fontán García-Rodrigo,
  • Begoña González,
  • Rosa Méndez,
  • Isabel Iturrate,
  • Ancor Sanz-García,
  • Almudena Villa,
  • Ana Sánchez-Azofra,
  • Begoña Quicios,
  • David Arribas,
  • Jesús Álvarez Rodríguez,
  • Pablo Patiño,
  • Marina Trigueros,
  • Miren Uriarte,
  • Alexandra Martín-Ramírez,
  • Cristina Arévalo Román,
  • José María Galván-Román,
  • Rosario García-Vicuña,
  • Julio Ancochea,
  • Cecilia Muñoz-Calleja,
  • Elena Fernández-Ruiz,
  • Rafael de la Cámara,
  • Carmen Suárez Fernández,
  • Isidoro González-Álvaro,
  • Diego A. Rodríguez-Serrano,
  • the PREDINMUN-COVID Group,
  • Jesús Sanz,
  • Pedro Casado,
  • Ángela Gutiérrez,
  • Azucena Bautista,
  • Pilar Hernández,
  • Nuria Ruiz Giménez,
  • Berta Moyano,
  • Paloma Gil,
  • María Jesús Delgado,
  • Pedro Parra,
  • Beatriz Sánchez,
  • Carmen Sáez,
  • Marta Fernández Rico,
  • Diego Domingo García,
  • Teresa Alarcón Cavero,
  • María Auxiliadora Semiglia Chong,
  • Ainhoa Gutiérrez Cobos,
  • Santos Castañeda,
  • Irene Llorente,
  • Eva G. Tomero,
  • Noelia García Castañeda,
  • Nuria Montes,
  • Cristina Dominguez Peña,
  • David Jiménez Jiménez,
  • Pablo Villamayor,
  • Alfonso Canabal,
  • Tamara Alonso,
  • Carolina Cisneros,
  • Claudia Valenzuela,
  • Francisco Javier García Pérez,
  • Rosa María Girón,
  • Javier Aspa,
  • Celeste Marcos,
  • M. del Perpetuo Socorro Churruca,
  • Enrique Zamora,
  • Adrián Martínez,
  • Mar Barrio Mayo,
  • Rosalina Henares Espi,
  • Francisco Sánchez-Madrid,
  • Enrique Martín Gayo,
  • Ildefonso Sánchez-Cerrillo,
  • Ana Marcos Jimenez,
  • Pedro Martínez-Fleta,
  • Celia López-Sanz,
  • Ligia Gabrie,
  • Luciana del Campo Guerola,
  • Reyes Tejedor,
  • Rosa Carracedo Rodríguez

DOI
https://doi.org/10.3389/fmed.2022.855639
Journal volume & issue
Vol. 9

Abstract

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BackgroundInterleukin 6 (IL6) levels and SARS-CoV-2 viremia have been correlated with COVID-19 severity. The association over time between them has not been assessed in a prospective cohort. Our aim was to evaluate the relationship between SARS-CoV-2 viremia and time evolution of IL6 levels in a COVID-19 prospective cohort.MethodsSecondary analysis from a prospective cohort including COVID-19 hospitalized patients from Hospital Universitario La Princesa between November 2020 and January 2021. Serial plasma samples were collected from admission until discharge. Viral load was quantified by Real-Time Polymerase Chain Reaction and IL6 levels with an enzyme immunoassay. To represent the evolution over time of both variables we used the graphic command twoway of Stata.ResultsA total of 57 patients were recruited, with median age of 63 years (IQR [53–81]), 61.4% male and 68.4% Caucasian. The peak of viremia appeared shortly after symptom onset in patients with persistent viremia (more than 1 sample with > 1.3 log10 copies/ml) and also in those with at least one IL6 > 30 pg/ml, followed by a progressive increase in IL6 around 10 days later. Persistent viremia in the first week of hospitalization was associated with higher levels of IL6. Both IL6 and SARS-CoV-2 viral load were higher in males, with a quicker increase with age.ConclusionIn those patients with worse outcomes, an early peak of SARS-CoV-2 viral load precedes an increase in IL6 levels. Monitoring SARS-CoV-2 viral load during the first week after symptom onset may be helpful to predict disease severity in COVID-19 patients.

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