Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou, 450016, China.
Immunogenetics. 2020 Oct;72(8):431-437. doi: 10.1007/s00251-020-01179-1. Epub 2020 Oct 17.
This study aimed to evaluate the association of interleukin-6 (IL-6) level with the poor outcomes in coronavirus disease 2019 (COVID-19) patients by utilizing a meta-analysis based on adjusted effect estimates. We searched the keywords from PubMed, Web of Science, and EMBASE on August 14, 2020. The pooled effects and 95% confidence interval (95% CI) were estimated by Stata 11.2. Subgroup analysis and meta-regression were performed to explore the source of heterogeneity. Sensitivity analysis was implemented to assess the stability of the results. Begg's test and Egger's test were conducted to assess the publication bias. Sixteen articles with 8752 COVID-19 patients were finally included in the meta-analysis. The results based on random-effects model indicated that elevated value of IL-6 was significantly associated with adverse outcomes in patients with COVID-19 (pooled effect = 1.21, 95% CI 1.13-1.31, I = 90.7%). Subgroup analysis stratified by disease outcomes showed consistent results (severe: pooled effect = 1.18, 95% CI 1.05-1.31; ICU (intensive care unit) admission: pooled effect = 1.90, 95% CI 1.04-3.47; death: pooled effect = 3.57, 95% CI 2.10-6.07). Meta-regression indicated that study design was a source of heterogeneity. Publication bias was existent in our analysis (Begg's test: P = 0.007; Egger's test: P < 0.001). In conclusion, the elevated IL-6 level is an independent risk factor associated with adverse outcomes in patients with COVID-19.
本研究旨在通过基于调整后效应估计的荟萃分析，评估白细胞介素 6 (IL-6) 水平与 2019 年冠状病毒病 (COVID-19) 患者不良结局的相关性。我们于 2020 年 8 月 14 日在 PubMed、Web of Science 和 EMBASE 上使用关键词进行了搜索。使用 Stata 11.2 估计汇总效应和 95%置信区间 (95%CI)。进行亚组分析和 meta 回归以探索异质性的来源。进行敏感性分析以评估结果的稳定性。使用 Begg 检验和 Egger 检验评估发表偏倚。最终纳入了 16 项包含 8752 例 COVID-19 患者的研究进行荟萃分析。基于随机效应模型的结果表明，IL-6 升高与 COVID-19 患者的不良结局显著相关（汇总效应 = 1.21，95%CI 1.13-1.31，I = 90.7%）。按疾病结局分层的亚组分析显示出一致的结果（重症：汇总效应 = 1.18，95%CI 1.05-1.31；入住重症监护病房（ICU）：汇总效应 = 1.90，95%CI 1.04-3.47；死亡：汇总效应 = 3.57，95%CI 2.10-6.07）。Meta 回归表明，研究设计是异质性的来源。我们的分析存在发表偏倚（Begg 检验：P = 0.007；Egger 检验：P < 0.001）。总之，IL-6 水平升高是 COVID-19 患者不良结局的独立危险因素。
