Frontiers in Pharmacology (Jul 2020)

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

  • Zeming Liu,
  • Jinpeng Li,
  • Danyang Chen,
  • Rongfen Gao,
  • Wen Zeng,
  • Sichao Chen,
  • Yihui Huang,
  • Jianglong Huang,
  • Wei Long,
  • Man Li,
  • Liang Guo,
  • Xinghuan Wang,
  • Xiaohui Wu

DOI
https://doi.org/10.3389/fphar.2020.01093
Journal volume & issue
Vol. 11

Abstract

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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.

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