Background The association of pro-inflammatory markers such as interleukin-6 (IL-6) and other biomarkers with severe coronavirus disease 2019 (COVID-19) is of increasing interest, however their kinetics, response to current COVID-related treatments, association with disease severity and comparison with other disease states associated with potential cytokine storm (CS) such as Staphylococcus aureus bacteraemia (SAB) are ill-defined. Methods A cohort of 55 hospitalized SARS-CoV-2 positive patients was prospectively recruited – blood sampling was performed at baseline, post-treatment and hospital discharge. Serum IL-6, C-reactive protein (CRP) and other laboratory investigations were compared between treatment groups and across timepoints. Acute serum IL-6 and CRP levels were then compared to those with suspected COVID-19 (SCOVID) and age and sex matched patients with SAB and patients hospitalized for any non-infectious condition (NIC). Results IL-6 was elevated at admission in the SARS-CoV-2 cohort but at lower levels compared to matched SAB patients. Median (IQR) IL-6 at admission was 73.89 pg/mL (30.9, 126.39) in SARS-CoV-2 compared to 92.76 pg/mL (21.75, 246.55) in SAB (p=0.017); 12.50 pg/mL (3.06, 35.77) in patients with NIC; and 95.51 pg/mL (52.17, 756.67) in SCOVID. Median IL-6 and CRP levels decreased between admission and discharge timepoints. This reduction was amplified in patients treated with remdesivir and/or dexamethasone. CRP and bedside vital signs were the strongest predictors of COVID-19 severity. Conclusions Knowledge of the kinetics of IL-6 did not offer enhanced predictive value for disease severity in COVID-19 over common investigations such as CRP and vital signs.
【저자키워드】 SARS-CoV-2, Cytokine storm, acute respiratory distress syndrome, interleukin-6, C-reactive protein, Sepsis, Staphylococcus aureus bacteraemia, 【초록키워드】 COVID-19, Dexamethasone, coronavirus disease, Coronavirus disease 2019, Biomarker, Hospitalized, IL-6, disease severity, COVID-19 severity, interleukin-6, Remdesivir, C-reactive protein, CRP, cytokine, discharge, Predictive value, serum, Kinetics, Cohort, interleukin, Patient, vital signs, vital sign, predictor, disease, Admission, patients, Blood, association, marker, Staphylococcus aureus, the strongest, Predictive, C-reactive protein (CRP, reduction, Serum IL-6, severe coronavirus disease, CRP levels, pro-inflammatory markers, hospital discharge, treatment group, treatment groups, CRP level, blood sampling, timepoints, non-infectious, offer, pro-inflammatory, laboratory investigation, Result, amplified, recruited, elevated, was performed, age and sex, baseline, IQR, NIC, patients hospitalized, patients treated, SARS-CoV-2 positive patient, the SARS-CoV-2, 【제목키워드】 COVID-19, clinical, response, Prospective, longitudinal, role,