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Interleukin-6 role in the severity of COVID-19 and intensive care unit stay length
Ruqaya Muhammed Ghareeb Taher Al Barzin1, Shler Ghafour Raheem1, Pinar Khalid Khudhur1
1Microbiology Unit, Department of Basic Science, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region-Iraq.
Insights
Elevated interleukin-6 (IL-6) levels in COVID-19 patients correlate with increased disease severity and longer intensive care unit (ICU) stays. This highlights IL-6 as a potential biomarker for critical illness progression in COVID-19.
Area of Science:
- Immunology
- Infectious Diseases
- Critical Care Medicine
Background:
- COVID-19 pathogenesis involves a 'cytokine storm,' with Interleukin-6 (IL-6) exacerbating immune responses.
- Understanding IL-6 dynamics is crucial for evaluating disease severity and patient outcomes.
Purpose of the Study:
- To investigate the association between Interleukin-6 (IL-6) levels and COVID-19 disease severity.
- To explore the relationship between IL-6, nutritional status, and intensive care unit (ICU) admission.
Main Methods:
- A cross-sectional study of 48 laboratory-confirmed COVID-19 patients.
- IL-6 levels measured using electrochemiluminescence immunoassay (ECLIA).
- Nutritional status assessed via Subjective Global Assessment (SGA) and calorie intake calculations.
Main Results:
- ICU-admitted patients exhibited significantly higher IL-6 levels compared to ward patients (p=0.001).
- Patients hospitalized for over 7 days showed markedly elevated IL-6 levels (119.2±28.3 pg/ml) versus those hospitalized for less than 7 days (89.04±34.1 pg/ml).
- No significant differences in nutritional status or albumin levels were found between ICU and ward patients.
Conclusions:
- IL-6 levels are associated with COVID-19 disease severity and duration of ICU stay.
- Elevated IL-6 may serve as a biomarker for predicting critical illness and prolonged hospitalization in COVID-19 patients.
- Nutritional status did not significantly correlate with ICU admission in this cohort.
Abstract:
Evaluation of cytokine production in COVIID-19 disease, in which the cytokine storm is one of the most important pathological features in complicated cases, especially interleukin 6 as a pre-inflammatory cytokine that exacerbates the immune response, could help determine the pathophysiology of the disease. Examining the level of this cytokine along with other related factors can help to better understand the pathogenesis of this disease. In this cross-sectional study, 48 patients with COVID-19 whose disease was confirmed by swap testing were evaluated. The demographic information of the individuals, the symptoms of the disease, and the ward in which they were admitted were recorded. Blood samples were taken from patients to test for interleukin-6 levels by electrochemiluminescence immunoassay (ECLIA, Roche Diagnostics). Due to the lack of specific treatment protocols for patients and the use of supportive treatments based on meeting the nutritional needs for all patients, blood albumin levels and nutritional status of patients were also evaluated using Subjective Global Assessment (SGA) Form. Their calorie intake was assessed by calculating the number of calories received based on the type of nutrition and compared to the required amount calculated through the Harris-Benedict equation. 48 laboratory-confirmed 2019-nCoV infected patients were included in the study with the mean age of 46.4 ± 8.3 years. 21 patients were admitted to the intensive care unit (ICU). There was no significant difference between the ICU admitted and patients admitted inward in terms of demographic characteristics, and history of previous diseases (p > 0.05). The average interleukin 6 (IL-6) in patients was 72.3±34.4 pg/ml. ICU admitted patients had higher IL6 levels (p=0.001). The mean interleukin 6 level was 89.04±34.1 pg/ml in patients admitted for less than 7 days and it was significantly higher (119.2±28.3) in patients hospitalized for more than 7 days (p=0.001). there was no significant difference in terms of nutritional status and albumin level between ICU admitted and ward admitted patients (p >0.05). Our study shows that there may be possible associations of IL6 and disease severity and ICU stay length.
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