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Interleukin-6 in Critical Coronavirus Disease 2019, a Driver of Lung Inflammation of Systemic Origin?
Nikolai Ravn Aarskog1, Hans Christian Aass2, Jan Cato Holter3,4
1Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
Abstract:
To examine whether interleukin-6 in critical coronavirus disease 2019 is higher in arterial than in central venous blood, as a sign of predominantly local pulmonal rather than systemic interleukin-6 production.
Design:
Prospective cohort pilot study with repeated weekly measurements of interleukin-6 in arterial and central venous blood. Respiratory function, assessed with Pao2/Fio2 ratio, was measured at the time of blood sampling.
Setting:
ICU at a university hospital.
Subjects:
Nine adult patients with critical coronavirus disease 2019, actively treated and receiving mechanical ventilation.
Measurements And Main Results:
No difference between arterial and central venous interleukin-6 was found. There was a significant negative relationship between interleukin-6 concentration and P/F ratio in both arterial (p = 0.04) and central venous (p = 0.03) blood.
Conclusions:
The absence of an arteriovenous interleukin-6 difference implies that interleukin-6 in critical coronavirus disease 2019 is mainly produced outside the lungs as part of a systemic inflammatory response syndrome and act as a driver of local inflammation and damage in the lungs.
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