Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients
Background: The present study was undertaken to determine the levels of interleukin-6 (IL-6) and evaluate its association with clinical presentation, severity, radiological imaging, management, and outcome in coronavirus disease (COVID-19) infection. Methods: The present study included 132 admitted...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2020-07-01
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| Series: | Indian Journal of Medical Specialities |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/INJMS.INJMS_63_20 |
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| author | Sudhir Bhandari Govind Rankawat Ajeet Singh Dileep Wadhwani Bhoopendra Patel |
| author_facet | Sudhir Bhandari Govind Rankawat Ajeet Singh Dileep Wadhwani Bhoopendra Patel |
| author_sort | Sudhir Bhandari |
| collection | DOAJ |
| description | Background:
The present study was undertaken to determine the levels of interleukin-6 (IL-6) and evaluate its association with clinical presentation, severity, radiological imaging, management, and outcome in coronavirus disease (COVID-19) infection.
Methods:
The present study included 132 admitted COVID-19 patients, categorized into three groups. Group 1 had IL-6 within the normal reference range, Group 2 had IL-6 raised up to ten times the upper normal limit (UNL), and Group 3 had IL-6 level raised > ten times the UNL. The patient's data concerning medical history, clinical manifestations, laboratory findings, radiological imaging, management, and outcome were extracted from their medical records for subsequent evaluation, interpretation, and association among the groups.
Results:
COVID-19 patients with raised IL-6 levels exhibited frequent symptomatic presentations, severity, and critical illness, especially with extremely high IL-6 levels (P < 0.001). Radiological findings in terms of a digital chest radiograph and high-resolution computed tomography (CT) chest indicated severe lung involvement in patients with extremely high IL-6 levels (P < 0.05). The majority of patients with extremely raised IL-6 levels were associated with the classic COVID-19 CT images (P = 0.014). Patients with extremely raised IL-6 levels required intensive treatment as compared to normal IL-6 group in terms of tocilizumab therapy (P = 0.008), noninvasive ventilation (P < 0.001), and intensive care unit care (P = 0.009) associated with higher mortality (P = 0.046).
Conclusion:
Raised IL-6 levels in COVID-19 patients should be considered a risk factor for the severity of the disease, inflammatory storm, and rapid pulmonary invasion. There is an urgent need for establishing a treatment protocol in patients with extremely raised IL-6 levels. |
| format | Article |
| id | doaj-art-1b791c1737f548dab3eeec6e4890f7b8 |
| institution | Kabale University |
| issn | 0976-2884 0976-2892 |
| language | English |
| publishDate | 2020-07-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Medical Specialities |
| spelling | doaj-art-1b791c1737f548dab3eeec6e4890f7b82025-08-25T08:33:28ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Specialities0976-28840976-28922020-07-0111313213610.4103/INJMS.INJMS_63_20Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 PatientsSudhir BhandariGovind RankawatAjeet SinghDileep WadhwaniBhoopendra PatelBackground: The present study was undertaken to determine the levels of interleukin-6 (IL-6) and evaluate its association with clinical presentation, severity, radiological imaging, management, and outcome in coronavirus disease (COVID-19) infection. Methods: The present study included 132 admitted COVID-19 patients, categorized into three groups. Group 1 had IL-6 within the normal reference range, Group 2 had IL-6 raised up to ten times the upper normal limit (UNL), and Group 3 had IL-6 level raised > ten times the UNL. The patient's data concerning medical history, clinical manifestations, laboratory findings, radiological imaging, management, and outcome were extracted from their medical records for subsequent evaluation, interpretation, and association among the groups. Results: COVID-19 patients with raised IL-6 levels exhibited frequent symptomatic presentations, severity, and critical illness, especially with extremely high IL-6 levels (P < 0.001). Radiological findings in terms of a digital chest radiograph and high-resolution computed tomography (CT) chest indicated severe lung involvement in patients with extremely high IL-6 levels (P < 0.05). The majority of patients with extremely raised IL-6 levels were associated with the classic COVID-19 CT images (P = 0.014). Patients with extremely raised IL-6 levels required intensive treatment as compared to normal IL-6 group in terms of tocilizumab therapy (P = 0.008), noninvasive ventilation (P < 0.001), and intensive care unit care (P = 0.009) associated with higher mortality (P = 0.046). Conclusion: Raised IL-6 levels in COVID-19 patients should be considered a risk factor for the severity of the disease, inflammatory storm, and rapid pulmonary invasion. There is an urgent need for establishing a treatment protocol in patients with extremely raised IL-6 levels.https://journals.lww.com/10.4103/INJMS.INJMS_63_20coronavirus disease-19interleukin-6managementseverity of disease |
| spellingShingle | Sudhir Bhandari Govind Rankawat Ajeet Singh Dileep Wadhwani Bhoopendra Patel Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients Indian Journal of Medical Specialities coronavirus disease-19 interleukin-6 management severity of disease |
| title | Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients |
| title_full | Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients |
| title_fullStr | Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients |
| title_full_unstemmed | Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients |
| title_short | Evaluation of Interleukin-6 and its Association with the Severity of Disease in COVID-19 Patients |
| title_sort | evaluation of interleukin 6 and its association with the severity of disease in covid 19 patients |
| topic | coronavirus disease-19 interleukin-6 management severity of disease |
| url | https://journals.lww.com/10.4103/INJMS.INJMS_63_20 |
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