Background Interleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients have not been fully elucidated. Objective To validate whether IL-6 levels are associated with disease severity and mortality and to investigate whether dynamic changes in IL-6 levels might be a predictive factor for lung injury in COVID-19 patients. Methods This retrospective, single-center study included 728 adult COVID-19 patients and used data extracted from electronic medical records for analyses. Results The mortality rate was higher in the elevated IL-6 group than in the normal IL-6 group (0.16 vs 5%). Cox proportional hazards and logistic regression analyses for survival (adjusted hazard ratio, 10.39; 95% confidence interval [CI], 1.09–99.23; p = 0.042) and disease severity (adjusted odds ratio, 3.56; 95% CI, 2.06–6.19; p < 0.001) revealed similar trends. Curve-fitting analyses indicated that patient computed tomography (CT) scores peaked on days 22 and 24. An initial decline in IL-6 levels on day 16 was followed by resurgence to a peak, nearly in tandem with the CT scores. Conclusion Increased IL-6 level may be an independent risk factor for disease severity and in-hospital mortality and dynamic IL-6 changes may serve as a potential predictor for lung injury in Chinese COVID-19 patients. These findings may guide future treatment of COVID-19 patients.
【저자키워드】 COVID-19, SARS-CoV-2, interleukin-6, Infectious disease, Lung injury, CT scores, 【초록키워드】 Treatment, coronavirus disease, Mortality, IL-6, disease severity, Computed tomography, survival, Patient, Logistic regression, mortality rate, change, in-hospital mortality, COVID-19 patients, retrospective, Analysis, COVID-19 patient, Predictive, Proinflammatory cytokine, Prognostic value, adjusted odds ratio, 95% CI, 95% confidence interval, adjusted hazard ratio, Chinese, single-center study, independent risk factor, objective, electronic medical record, initial, Result, reported, indicated, peaked, elevated, changes in, analyses, Increased, adult COVID-19 patient, Cox proportional hazard, IL-6 level, used data, 【제목키워드】 change, Indicator, dynamic, Level,