Interleukin 6 and Its Correlation with COVID-19 in Terms of Outcomes in an Intensive Care Unit of a Rural Hospital: A Cross-sectional Study

Abstract

A bstract Background Interleukin 6 (IL-6) encoded by the gene coded as IL 6 acts as a proinflammatory cytokine as well as an anti-inflammatory myokine. It is postulated that IL 6 is associated directly with the severity of coronavirus disease-2019 (COVID-19). Another domain that is thought to predict the severity of COVID-19 is the neutrophil:lymphocyte (N:L) ratio; a higher N:L ratio is postulated to be related to more severe outcomes. Thus, the present study was aimed to establish a correlation of COVID-19 with IL-6 in terms of clinical outcomes. We had also tried to find the relationship between IL-6 and N:L ratio and high-resolution computed tomography (HRCT) score. Methods We have conducted a cross-sectional study of 200 patients who were admitted to the intensive care unit (ICU) with reverse transcriptase-polymerase chain reaction (RT-PCR) positive for COVID-19 from January to May 2021. Serum IL-6, N:L ratio, and HRCT chest were conducted on admission. Result Out of 200 patients who were admitted to the ICU with COVID-19, while the IL-6 was higher in patients with increased N:L ratio and HRCT score, the association of IL-6 with clinical outcomes in terms of discharged and expired was found to be statistically not significant. Conclusion Serum IL-6 was found not to be a potent marker for clinical outcomes in ICU patients in terms of death vs survived. However, the IL-6 levels on admission can be correlated with the computed tomography (CT) severity scores as well as N:L ratio of patients admitted to an ICU. How to cite this article Talwar D, Kumar S, Acharya S, Raisinghani N, Madaan S, Hulkoti V, et al . Interleukin 6 and Its Correlation with COVID-19 in Terms of Outcomes in an Intensive Care Unit of a Rural Hospital: A Cross-sectional Study. Indian J Crit Care Med 2022;26(1):39–42.

Inflammatory Biomarkers Associated with In-Hospital Mortality in Critical COVID-19 Patients

“…[ 37 ] However, in this analysis, critical patients are not considered separately. By contrast to our results, a study conducted in the ICU of a rural hospital in India demonstrated no association between IL-6 and clinical outcomes [ 38 ]. This contradictory finding highlights the need for larger, multicentric studies investigating the predictive value of inflammatory biomarkers in critical COVID-19 patients.…”

Secretory Phospholipase A2 and Interleukin-6 Levels as Predictive Markers of the Severity and Outcome of Patients with COVID-19 Infections

“…This study also shows that the level of IL-6 increases in seriously ill patients and in the cases of unfavorable outcomes and it is correlated with the severity and death in patients ( Table 2 , Table 5 , Table 6 and Table 7 , Figure 1 , Figure 2 and Figure 3 ). Our results are consistent with the research of other authors evaluating the prognostic significance of IL-6 in COVID-19 infections [ 37 ]. For example, in a retrospective single-center study conducted on 728 patients with COVID-19, the prognostic significance of elevated IL-6 levels for assessing mortality and a severe disease course was studied [ 38 ].…”

Impact of P-selectin–PSGL-1 Axis on Platelet-Endothelium-Leukocyte Interactions in Fatal COVID-19

“…However, cytokine mRNA levels were high in the lung of cases with very short disease course ( Supplementary Table S2 ), whereas no significant levels were detected in the other patients, congruent with a decrease in serum IL-6 levels before death. 32 This finding suggests that the massive secretion of cytokines occurs early in disease, but it should not be considered a reliable marker of disease severity due to its transiency. In fact, the increase of cytokine is rapidly followed by high and durable expression of P-selectin at tissue level in all stages of disease, representing a hallmark of COVID-19 cases.…”