Evaluation of Interleukin 6 Levels in Severe COVID-19 Patients

Yıl 2023, Cilt: 3 Sayı: 1, 20 - 25, 29.01.2023

Yıldız Okuturlar , İftihar Köksal , Yasemin Gündoğdu , Arzu Yüksel , Özgür Okuturlar , Fadıl Havas , Cem Gun

https://doi.org/10.56016/dahudermj.1220959

Öz

Objectives: Interleukin 6 (IL-6) plays a leading role in the proliferation and differentiation of immune cells. Level of IL-6 is manifestly increased under many inflammatory conditions, including cytokine release syndrome. We evaluated the IL-6 levels of patients who were hospitalized with the diagnosis of COVID-19.
Methods: In the study, the test results of 19 cases whose IL-6 levels were measured between March 11, 2020 and May 31, 2020 retrospectively. The inpatients in the covid service (Group 1) and the patients admitted to the Intensive Care Unit (ICU) of our hospital (Group 2) were compared and evaluated. In addition, patients with positive and negative RT-PCR test results were checked for IL-6.
Results: While 8 (Group 1) of 19 patients observed in the clinic were transferred to the ICU, 11 patients (Group 2) were observed in the covid service until their discharge. Group 1 IL-6 levels (median 34 pg/mL) and Group 2 IL-6 levels (median 116 pg/mL) were found to be high in both groups (p = 0,099). However, it was found to be significantly higher in patients with positive COVID-19 RT-PCR test (median 90.60 pg/mL) than in negative patients (median 29.90 pg/mL) (p = 0.018).
Conclusion: No significant difference in IL-6 levels between the patients who were monitored in the clinic and transferred to the ICU was found in this study. The significant difference between IL-6 levels among COVID-19 RT-PCR positive and negative patients reveals the importance of IL-6 level with regard to tocilizumab treatment in COVID-19 patients in cytokine storm.
Keywords: COVID-19, Interleukin 6, Cytokine Storm, Macrophage Activation Syndrome

Anahtar Kelimeler

COVID-19, Interleukin 6, Cytokine Storm, Macrophage Activation Syndrome

Kaynakça

• Zhang J, Hao Y, Ou W, Ming F, Liang G, Qian Y et al. Serum interleukin-6 is an indicator for severity in 901 patients with SARS-CoV-2 infection: a cohort study. J Transl Med. 2020;18(1).
• Chen T, Wu D, Chen H, Yan W, Yang D, Chen G et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;m1091.
• Galván-Román J, Rodríguez-García S, Roy-Vallejo E, Marcos-Jiménez A, Sánchez-Alonso S, Fernández-Díaz C. IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study. J Allergy Clinic Immunol. 2021;147(1):72-80.e8.
• Narazaki M, Kishimoto T. The Two-Faced Cytokine IL-6 in Host Defense and Diseases. Int J Mol Sci. 2018;19(11):3528.
• Swaroopa D, Bhaskar K, Mahathi T, Katkam S, Raju Y, Chandra N et al. Association of serum interleukin-6, interleukin-8, and Acute Physiology and Chronic Health Evaluation II score with clinical outcome in patients with acute respiratory distress syndrome. Indian J Crit Care Med. 2016;20(9):518-525.
• Herold T, Jurinovic V, Arnreich C, Hellmuth J, von Bergwelt-Baildon M. Level of IL-6 predicts respiratory failure in hospitalized symptomatic COVID-19 patients. 2020;146(1):128-136
• Chen W, Lan Y, Yuan X, Deng X, Li Y, Cai X. Detectable 2019-nCoV viral RNA in blood is a strong indicator for the further clinical severity. Emerg Microbes Infect. 2020;9(1):469-473.
• Antisitokin-Antiinflamatuar Tedaviler, Koagülopati Yönetimi . Covid19.saglik.gov.tr. 2022. https://covid19.saglik.gov.tr/TR-66341/antisitokin-antiinflamatuar-tedaviler-koagulopati-yonetimi.html (accessed February 2022)
• Scheller J, Chalaris A, Schmidt-Arras D, Rose-John S. The pro- and anti-inflammatory properties of the cytokine interleukin-6. Biochim Biophys Acta. 2011;1813(5):878-888.
• Barek M, Aziz M, Islam M. Impact of age, sex, comorbidities and clinical symptoms on the severity of COVID-19 cases: A meta-analysis with 55 studies and 10014 cases. Heliyon. 2020;6(12):e05684.
• Cagnacci A, Xholli A. Age-related difference in the rate of coronavirus disease 2019 mortality in women versus men. Am J Obstet Gynecol. 2020;223(3):453-454.
• Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-118.