Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a long-term care facility during Covid-19 outbreak

Abstract

Background Covid-19 is a disease with high morbidity and mortality among elderly residents of long-term care facilities (LTCF). During an outbreak of SARS-CoV-2 infection in the LTCF an effective screening tool is essential to identify the patients at risk for severe disease. We explored the role of interleukin 6 (IL-6) as a predictor for severe disease during the outbreak of Covid-19 in one LTCF in Slovakia. Methods We conducted a retrospective data analysis of cases of COVID-19, diagnosed during the outbreak in one LTCF in Slovakia between April 11, 2020, and May 5, 2020. Within 24 h after the diagnosis of Covid-19, clinical and laboratory screening was performed in the LTCF to identify patients in need of hospitalization. Patients with oxygen saturation below 90% were immediately referred to the hospital. Patients staying in the LFTC were monitored daily and those that developed hypoxemia were transferred to the hospital. We analyzed the association between the IL-6 at the initial assessment and development of hypoxemia during follow up and determined the cut-off of the IL-6 able to predict the development of hypoxemia requiring oxygen therapy. Results Fifty-three patients (11 men, 42 women) with diagnosed Covid-19 were included in the analysis. 19 (53%) patients developed hypoxemia during the disease. Patients with hypoxemia had significantly higher concentrations of IL-6, C-reactive protein, procalcitonin, fibrinogen, total bilirubin, aspartate aminotransferase and alanine aminotransferase at initial screening. ROC analyses identified IL-6 as the most robust predictor of hypoxemia. The concentration of IL-6 > 24 pg/mL predicted the development of hypoxemia with the sensitivity of 100% and specificity of 88.9%. The positive and negative predictive values were 76.9, and 100% respectively. Conclusions The concentration of IL-6 > 24 pg/mL at initial assessment predicted the development of hypoxemia requiring hospitalization with excellent sensitivity and good specificity. IL-6 appears as a potential predictor for the development of the severe Covid-19 and might serve for early identification of patients in need of hospitalization. Further studies are needed to evaluate the robustness of the use of IL-6 as an effective screening tool for the severe course of Covid-19.

Cell Population Data and Serum Polyclonal Immunoglobulin Free Light Chains in the Assessment of COVID-19 Severity

“…However, the study performed on our patients indicates significantly higher concentrations of ferritin and IL-6 in patients with COVID-19 requiring intensive care comparing with those hospitalized in non-ICU departments. With our results, we confirm observations made by other groups showing that IL-6 allows distinguishing between severe and nonsevere COVID-19 [ 38 , 39 , 40 , 41 , 42 ].…”

“…The researchers’ analysis of the ROC curve showed that IL-6 is the most powerful predictor of hypoxemia. On the other hand, the concentration of IL-6 above 24 pg/mL indicated the development of hypoxemia with a sensitivity of 100% and a specificity of 88.9% [ 38 ]. Parviz et al found that the level of IL-6, the level of ferritin, and hematological parameters including WBC and the number of lymphocytes and neutrophils had a direct positive correlation with the concentration of hemoglobin [ 39 ].…”

Beneficial Effects of novel Aureobasidium Pullulans strains produced Beta-1,3-1,6 Glucans on Interleukin-6 and D-Dimer levels in COVID-19 patients; results of a randomized multiple-arm pilot clinical study

“…Inhibition of IL-6 has been suggested as a novel target for managing dysregulated host responses in patients with COVID-19 [21]. In the current study, the IL-6 values were decreased from values predictive of higher mortality due to COVID-19 > 24 pg/ml [22] to normal values which were maintained in the beta glucan groups only while it increased to values predictive of higher mortality in the control groups at day 30 (figure 4). The significant and steady decrease in IL6 and D-Dimer (figure 4 and 5) substantiate the anti-inflammatory and anti-coagulation benefits of beta glucans.…”

Beneficial effects of novel aureobasidium pullulans strains produced beta-1,3-1,6 glucans on interleukin-6 and D-dimer levels in COVID-19 patients; results of a randomized multiple-arm pilot clinical study

“…Inhibition of IL-6 has been suggested as a novel target for managing dysregulated host responses in patients with COVID-19 [3] . In the current study, the IL-6 values were decreased from values predictive of higher mortality due to COVID-19 > 24 pg/ml [25] to normal values which were maintained in the beta glucan groups only while it increased to values predictive of higher mortality in the control groups at day 30 ( Fig. 3 A).…”