Introduction Coronavirus disease 2019 (COVID-19) appeared in China in December 2019 and has spread around the world. High Interleukin-6 (IL-6) levels in COVID-19 patients suggest that a cytokine storm may play a major role in the pathophysiology and are considered as a relevant parameter in predicting most severe course of disease. The aim of this study was to assess repeated IL-6 levels in critically ill COVID-19 patients admitted to our Intensive Care Unit (ICU) and to evaluate their relationship with patient’s severity and outcome. Methods We conducted a retrospective study on patients admitted to the ICU with a diagnosis of COVID-19 between March 10 (i.e. the date of the first admitted patients) and April 30, 2020. Demographic, clinical and laboratory data were collected at admission. On the day of IL-6 blood concentration measurement, we also collected results of D-Dimers, C-Reactive Protein, white blood cells and lymphocytes count, lactate dehydrogenase (LDH) and ferritin as well as microbiological samples, whenever present. Results Of a total of 65 patients with COVID-19 admitted to our ICU we included 41 patients with repeated measure of IL-6. There was a significant difference in IL-6 levels between survivors and non-survivors over time (p = 0.001); moreover, non survivors had a significantly higher IL-6 maximal value when compared to survivors (720 [349–2116] vs. 336 [195–646] pg/mL, p = 0.01). The IL-6 maximal value had a significant predictive value of ICU mortality (AUROC 0.73 [95% CI 0.57–0.89]; p = 0.01). Conclusions Repeated measurements of IL-6 can help clinicians in identifying critically ill COVID-19 patients with the highest risk of poor prognosis.
【초록키워드】 COVID-19, coronavirus disease, Coronavirus disease 2019, Cytokine storm, Lymphocytes, Mortality, IL-6, severity, intensive care unit, interleukin-6, LDH, C-reactive protein, risk, ferritin, Blood cells, cytokine, outcome, lactate dehydrogenase, ICU, Predictive value, Spread, China, Retrospective study, lymphocyte, Critically ill, White blood cell, pathophysiology, Patient, D-dimers, demographic, disease, Admission, patients, Blood, Lactate, Concentration, COVID-19 patient, critically ill COVID-19 patients, Predictive, blood concentration, admitted patients, White blood cells, significant difference, clinician, laboratory data, poor prognosis, help, AUROC, survivor, parameter, repeated, non-survivor, Course, Result, highest, collected, evaluate, conducted, significantly higher, diagnosis of COVID-19, IL-6 level, patients with COVID-19, 【제목키워드】 COVID-19, Retrospective analysis, Interleukine-6,