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Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19
Zeming Liu1, Jinpeng Li2, Danyang Chen1
1Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Insights
Elevated interleukin-6 (IL-6) levels are linked to increased COVID-19 severity and mortality. Dynamic IL-6 changes may predict lung injury, guiding future patient treatment strategies.
Area of Science:
- Immunology
- Infectious Diseases
- Critical Care Medicine
Background:
- Interleukin-6 (IL-6) is a proinflammatory cytokine implicated in COVID-19 severity and mortality.
- The prognostic value of dynamic IL-6 changes for lung injury in COVID-19 remains unclear.
Purpose of the Study:
- To determine if IL-6 levels correlate with COVID-19 severity and mortality.
- To investigate the predictive potential of dynamic IL-6 changes for lung injury in COVID-19 patients.
Main Methods:
- Retrospective analysis of 728 adult COVID-19 patients.
- Data extracted from electronic medical records.
- Statistical analyses including Cox regression and logistic regression.
Main Results:
- Higher mortality observed in patients with elevated IL-6 (5% vs 0.16%).
- Elevated IL-6 independently predicted disease severity (aOR 3.56) and mortality (aHR 10.39).
- Dynamic IL-6 changes mirrored computed tomography (CT) scores, peaking around days 22-24.
Conclusions:
- Increased IL-6 is an independent risk factor for COVID-19 severity and in-hospital mortality.
- Dynamic IL-6 monitoring may predict lung injury progression in COVID-19.
- Findings can inform clinical management of COVID-19 patients.
Background:
Interleukin-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.
Objective:
To 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.
Methods:
This retrospective, single-center study included 728 adult COVID-19 patients and used data extracted from electronic medical records for analyses.
Results:
The 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.
Conclusion:
Increased 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.
