Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis

Abstract Baseline IL-6 levels have been found to be non-predictive of subsequent outcomes following tocilizumab treatment, highlighting the need for more reliable predictive markers. To address this, a retrospective analysis was conducted on the clinical profiles, diagnostic tests, and follow-up pro...

Full description

Saved in:
Bibliographic Details
Main Authors: Panpan Liang, Yan Li, Li’e Meng, Yuting Li, Hailing Mai, Tao Li, Jiarui Ma, Junhui Ma, Jing Wang, Bing Zhuan, Wei Zhou
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-81028-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850216314815119360
author Panpan Liang
Yan Li
Li’e Meng
Yuting Li
Hailing Mai
Tao Li
Jiarui Ma
Junhui Ma
Jing Wang
Bing Zhuan
Wei Zhou
author_facet Panpan Liang
Yan Li
Li’e Meng
Yuting Li
Hailing Mai
Tao Li
Jiarui Ma
Junhui Ma
Jing Wang
Bing Zhuan
Wei Zhou
author_sort Panpan Liang
collection DOAJ
description Abstract Baseline IL-6 levels have been found to be non-predictive of subsequent outcomes following tocilizumab treatment, highlighting the need for more reliable predictive markers. To address this, a retrospective analysis was conducted on the clinical profiles, diagnostic tests, and follow-up prognoses of 60 patients with severe or critical COVID-19, all of whom were identified as experiencing a cytokine storm and subsequently received tocilizumab treatment. Among the patients, the overall survival rate during follow-up was 80%, with further analysis revealing that advanced age was an independent risk factor for adverse outcomes. Following tocilizumab administration, a statistically significant increase in IL-6 and D-dimer levels was observed, while markers such as C-reactive protein (CRP), procalcitonin (PCT), and fibrinogen demonstrated reductions compared to pre-treatment values. Specifically, IL-6 levels initially surged briefly after tocilizumab intervention before gradually diminishing. To assess the prognostic utility of IL-6, the Receiver Operating Characteristic (ROC) curve was employed, which yielded an area under the curve (AUC) of 0.812, indicating strong predictive capability, with a sensitivity of 100% and a specificity of 53.49%. The optimal cut-off value for IL-6 was identified at 147.79 pg/mL. In conclusion, IL-6 levels tend to rise transiently following tocilizumab therapy, before gradually declining. These post-treatment IL-6 measurements may serve as a valuable biomarker for assessing prognosis in patients undergoing this treatment.
format Article
id doaj-art-feb4d74f6b074d5dacdb7bf99400f20d
institution OA Journals
issn 2045-2322
language English
publishDate 2024-11-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-feb4d74f6b074d5dacdb7bf99400f20d2025-08-20T02:08:20ZengNature PortfolioScientific Reports2045-23222024-11-0114111110.1038/s41598-024-81028-3Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysisPanpan Liang0Yan Li1Li’e Meng2Yuting Li3Hailing Mai4Tao Li5Jiarui Ma6Junhui Ma7Jing Wang8Bing Zhuan9Wei Zhou10Department of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityClinical Medical College, Ningxia Medical UniversityDepartment of Critical Care Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityClinical Medical College, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityDepartment of Respiratory Medicine, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical UniversityAbstract Baseline IL-6 levels have been found to be non-predictive of subsequent outcomes following tocilizumab treatment, highlighting the need for more reliable predictive markers. To address this, a retrospective analysis was conducted on the clinical profiles, diagnostic tests, and follow-up prognoses of 60 patients with severe or critical COVID-19, all of whom were identified as experiencing a cytokine storm and subsequently received tocilizumab treatment. Among the patients, the overall survival rate during follow-up was 80%, with further analysis revealing that advanced age was an independent risk factor for adverse outcomes. Following tocilizumab administration, a statistically significant increase in IL-6 and D-dimer levels was observed, while markers such as C-reactive protein (CRP), procalcitonin (PCT), and fibrinogen demonstrated reductions compared to pre-treatment values. Specifically, IL-6 levels initially surged briefly after tocilizumab intervention before gradually diminishing. To assess the prognostic utility of IL-6, the Receiver Operating Characteristic (ROC) curve was employed, which yielded an area under the curve (AUC) of 0.812, indicating strong predictive capability, with a sensitivity of 100% and a specificity of 53.49%. The optimal cut-off value for IL-6 was identified at 147.79 pg/mL. In conclusion, IL-6 levels tend to rise transiently following tocilizumab therapy, before gradually declining. These post-treatment IL-6 measurements may serve as a valuable biomarker for assessing prognosis in patients undergoing this treatment.https://doi.org/10.1038/s41598-024-81028-3COVID-19IL6TocilizumabPrognosis
spellingShingle Panpan Liang
Yan Li
Li’e Meng
Yuting Li
Hailing Mai
Tao Li
Jiarui Ma
Junhui Ma
Jing Wang
Bing Zhuan
Wei Zhou
Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
Scientific Reports
COVID-19
IL6
Tocilizumab
Prognosis
title Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
title_full Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
title_fullStr Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
title_full_unstemmed Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
title_short Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis
title_sort prognostic significance of serum interleukin 6 in severe critical covid 19 patients treated with tocilizumab a detailed observational study analysis
topic COVID-19
IL6
Tocilizumab
Prognosis
url https://doi.org/10.1038/s41598-024-81028-3
work_keys_str_mv AT panpanliang prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT yanli prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT liemeng prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT yutingli prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT hailingmai prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT taoli prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT jiaruima prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT junhuima prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT jingwang prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT bingzhuan prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis
AT weizhou prognosticsignificanceofseruminterleukin6inseverecriticalcovid19patientstreatedwithtocilizumabadetailedobservationalstudyanalysis