IL-6 may be a good biomarker for earlier detection of COVID-19 progression

Wang, Changsong; Fei, Dongsheng; Li, Xueting; Zhao, Mingyan; Yu, Kaijiang

doi:10.1007/s00134-020-06065-8

Cited by 56 publications

(53 citation statements)

References 2 publications

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“…Furthermore, increased levels of IL-6, BUN, and CK were associated with the development of SARS-CoV-2 infection-induced sepsis, indicating that an uncontrolled inflammatory response and multiple organ dysfunction were major characteristics for viral sepsis. The increase in IL-6 production was found to be an independent risk factor for the progression to critical illness among septic COVID-19 patients, which was consistent with the report by Wang and colleagues (29). A cytokine storm is deemed to be the main cause but is a difficult issue to resolve for multiple organ damage induced by severe viral infection; moreover, the source of cytokines varies and remains vague.…”

Section: Discussionsupporting

confidence: 87%

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The Clinical Features and Prognostic Assessment of SARS-CoV-2 Infection-Induced Sepsis Among COVID-19 Patients in Shenzhen, China

et al. 2020

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Background: The outbreak of the novel coronavirus disease (COVID-19) that began in December 2019 has posed a great threat to human health and caused a significant loss of life. In Shenzhen, 465 patients were confirmed to have COVID-19 as of August 31, 2020. In the present study, we aimed to describe the clinical characteristics of COVID-19 patients in Shenzhen and identify risk factors for the development of viral sepsis. Methods: In this retrospective study, patients who were confirmed to have a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and were admitted to the Third People's Hospital of Shenzhen from January 11 to April 27, 2020 were included in the cohort. Clinical data were extracted and followed up to May 10, 2020, by using predesigned data collection forms. Results: A total of 422 hospitalized COVID-19 patients were enrolled in this study, including 97 (23%) patients with viral sepsis at hospital admission and 325 (77%) non-septic patients. Patients with sepsis were much older than those without sepsis (57 vs. 43 years, P < 0.001) and presented with more comorbidities. Septic patients showed multiple organ dysfunction and significant abnormalities in immune-and inflammation-related biomarkers, and had poorer outcomes when compared to those without sepsis. Increased levels of interleukin-6, blood urea nitrogen, and creatine kinase were associated with the development of SARS-CoV-2-induced sepsis, and an elevated production of interleukin-6 was found to be an independent risk factor for the progression to critical illness among septic COVID-19 patients. Ren et al. SARS-CoV-2 Infection-Induced Sepsis Conclusions: SARS-CoV-2 infection-induced sepsis is critically involved in the severity and prognosis of COVID-19 patients by characterizing both aberrant immune response and uncontrolled inflammation. The development of sepsis might contribute to multiple organ dysfunction and poor outcomes in COVID-19 patients during hospitalization.

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Section: Discussionsupporting

confidence: 87%

“…The hyper-inflammatory response is regarded as an important cause of lung injury in COVID-19 patients (29,30). Herein, CRP and IL-6 levels were significantly higher in patients with sepsis than in those without sepsis at hospital admission.…”

Section: Discussionmentioning

confidence: 88%

The Clinical Features and Prognostic Assessment of SARS-CoV-2 Infection-Induced Sepsis Among COVID-19 Patients in Shenzhen, China

et al. 2020

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“…To address this postulation, our further meta-analysis depicted remarkably raised circulating IL-10 levels in severe COVID-19 patients compared with non-severe COVID-19 patients. Our main finding from this meta-analysis may help clarify the inconclusive results derived from several observational studies unveiling that circulating IL-10 levels were higher in severe cases than that in non-severe cases, but the difference is not statistically significant [ 12 , 14 , 15 , 17 , 22 , 24 ]. As regards IL-10 levels relevant to mortality, when 2 previous studies were considered, a study by Huang et al [ 28 ] evinced no statistically significant difference in circulating IL-10 levels between non-survivors and survivors.…”

Section: Discussionmentioning

confidence: 83%

“…For this reason, the uncontrolled overproduction of inflammatory cytokines is considered to be one of the major contributing mediators of severe COVID-19 and mortality in the patients. This assumption has been partially addressed by a number of clinical studies, which denoted the significant associations between circulating levels of inflammatory cytokines, particularly IL-6 and the severity and mortality of COVID-19 [ 10 – 13 , 17 – 22 , 26 , 28 – 30 , 32 , 33 ]. More precisely, a previous meta-analysis [ 34 ] added another piece of supporting data, revealing that circulating IL-6 levels in severe COVID-19 patients was significantly higher than that in the non-severe patients.…”

Section: Discussionmentioning

confidence: 99%

Circulating Levels of Interleukin-6 and Interleukin-10, But Not Tumor Necrosis Factor-Alpha, as Potential Biomarkers of Severity and Mortality for COVID-19: Systematic Review with Meta-analysis

et al. 2020

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Purpose Cytokine storm, an uncontrolled overproduction of inflammatory cytokines contributing to an aberrant systemic inflammatory response, is a major pathological feature of acute respiratory distress syndromes being severe manifestations of COVID-19, thus highlighting its potential as a biomarker and therapeutic target for COVID-19. We aimed to determine associations of circulating levels of inflammatory cytokines with severity and mortality of COVID-19 by systematic review and meta-analysis. Methods A comprehensive literature search in electronic databases consisting of PubMed, Scopus, and Cochrane Library and in a hand searching of reference lists from inception to July 31, 2020, was performed using the following search terms: COVID-19, interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α). Mean difference (MD) from individual studies was pooled using a random-effects model. Quality assessment, publication bias, meta-regression, subgroup, and sensitivity analyses were performed. Results A total of 6212 COVID-19 patients from 24 eligible studies were included. Compared with non-severe COVID-19 patients, systemic levels of IL-6 and IL-10, but not TNF-α, were significantly elevated in severe COVID-19 patients (MD = 18.63, 95% CI: 10.91, 26.35, P < 0.00001; MD = 2.61, 95% CI: 2.00, 2.32, P < 0.00001; respectively). For COVID-19 mortality, circulating levels of IL-6, IL-10, and TNF-α were found to be significantly increased in non-survivors when compared with survivors (MD = 57.82, 95% CI: 10.04, 105.59, P = 0.02; MD = 4.94, 95% CI: 3.89, 6.00, P < 0.00001; MD = 5.60, 95% CI: 4.03, 7.17, P < 0.00001; respectively). Conclusion Circulating levels of IL-6 and IL-10 might have great potential as biomarkers for the disease severity and mortality in COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-020-00899-z.

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“…Patienten im Allgemei-nen anwendbar sind, und ob sich davon für die Patienten vorteilhafte Behandlungen ableiten lassen[20]. So wird sich erst nach detaillierter Analyse klinischer Daten und idealerweise durch klinische Studien beantworten lassen, ob ein Abweichen von den Prinzipien einer Lungen-protektiven Beatmung für COVID-Patienten unter bestimmten Bedingungen sinnvoll oder gar schädlich ist.…”

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COVID-19 aus Sicht der Intensivmedizin

Stecher¹,

Stemmler²,

Eichenauer³

et al. 2020

Dtsch Med Wochenschr

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Approx. 93 % of COVID-19 infections are mild, and not all severely ill patients are transferred to the intensive care unit. But the Corona crisis implies high demands on intensive care medicine. Many treatment modalities of COVID patients are “best practice”, but some aspects remain unclear at present. This article deals with diagnostics, monitoring and therapy with COVID-19 patients in intensive care units and with a suitable hygiene concepts.A hygiene concept is obligatory and must ensure – in addition to general measures – the training of employees and the hygienic discharge of material. Ideally, a cohort isolation is implemented.Monitoring of patients with COVID-19 is not different from other intensive care patients and should be adapted to the clinical situation of the individual patient. In laboratory analysis the typical abnormality of COVID-19 patients should be taken into account. In case of increasing inflammatory parameters, fungal infections should be tested.Due to the formation of aerosols, disconnection of the respiratory system must be avoided in invasive ventilation. If a disconnection from the respirator is necessary, the tube should be disconnected. After extubation, an intermittent NIV treatment for atelectase prophylaxis can be performed.

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IL-6 may be a good biomarker for earlier detection of COVID-19 progression

Cited by 56 publications

References 2 publications

The Clinical Features and Prognostic Assessment of SARS-CoV-2 Infection-Induced Sepsis Among COVID-19 Patients in Shenzhen, China

The Clinical Features and Prognostic Assessment of SARS-CoV-2 Infection-Induced Sepsis Among COVID-19 Patients in Shenzhen, China

Circulating Levels of Interleukin-6 and Interleukin-10, But Not Tumor Necrosis Factor-Alpha, as Potential Biomarkers of Severity and Mortality for COVID-19: Systematic Review with Meta-analysis

COVID-19 aus Sicht der Intensivmedizin

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