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 illness and death. 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 hours 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.

Soluble angiotensin-converting enzyme 2 as a prognostic biomarker for disease progression in patients infected with SARS-CoV-2

“…Overall, median levels of CRP, GDF-15, IL-6 and sFlt-1 were significantly higher in patients with SARS-CoV-2 who had the most severe clinical outcome in all comparisons. These findings are consistent with previously published studies that have reported the value of these biomarkers for disease severity in patients infected with SARS-CoV-2 (16,20,22,24). Across all patients with SARS-CoV-2, sACE2 levels were significantly lower than in controls, which could indicate a reduced amount of mACE2 susceptible to cleavage by ADAM-17.…”

Efficient control of IL-6, CRP and Ferritin in Covid-19 patients with two variants of Beta-1,3-1,6 glucans in combination, within 15 days in an open-label prospective clinical trial

“…The difference between day 7 and day 15 values were statically significant. Coronavirus disease 2019 (Covid-19) caused by the zoonotic novel Coronavirus called SARS-CoV-2 has been wreaking havoc around the world ever since it was declared a pandemic by WHO on March 11, 2020 [1]. The recent discovery of a highly mutated coronavirus variant in South Africa has further triggered a global scramble [2].…”

“…The recent discovery of a highly mutated coronavirus variant in South Africa has further triggered a global scramble [2]. While most patients experience only a mild self-limiting disease, up to 20% of known cases of Covid-19 develop severe pneumonia resulting in acute respiratory distress syndrome (ARDS) and acute hypoxemic respiratory failure leading to death in 1% of cases [3]. The risk of mortality in Covid-19 is higher in a presence of comorbidities such as cardiovascular diseases, diabetes mellitus and obesity [1].…”

SARS-CoV-2 infects human adipose tissue and elicits an inflammatory response consistent with severe COVID-19

“…S11A) in SARS-CoV-2 infected versus mock-infected SVC. We selected IL-6 due to its high presence in severe cases of COVID-19 (65), its association with low-grade inflammation in obese individuals (66), and its likely role in COVID-19 immunopathogenesis (67). SARS-CoV-2infection drove significantly increased IL-6 expression in SAT (n=6) (fig.…”