Jain Vikram, Kumar Pratap, Panda Prasan Kumar, Suresh Mohan, Kaushal Karanvir, Mirza Anissa A, Raina Rohit, Saha Sarama, Omar Balram J, Subbiah Vivekanandhan
Department of Internal Medicine (ID Division), AIIMS Rishikesh, Rishikesh 249203, India.
Department of Biochemistry, AIIMS Rishikesh, Rishikesh 249203, India.
Vaccines (Basel). 2022 Oct 24;10(11):1786. doi: 10.3390/vaccines10111786.
COVID-19 has caused devastating effects worldwide ever since its origin in December 2019. IL-6 is one of the chief markers used in the management of COVID-19. We conducted a longitudinal study to investigate the role of IL-6 in diagnosis, treatment, and prognosis of COVID-19-related cytokine storm. Patients with COVID-19 who were admitted at AIIMS Rishikesh from March to December 2020 were included in the study. Patients with no baseline IL-6 value at admission and for whom clinical data were not available were excluded. Clinical and laboratory data of these patients were collected from the e-hospital portal and entered in an excel sheet. Correlation was seen with other inflammatory markers and outcomes were assessed using MS Excel 2010 and SPSS software. A total of 131 patients were included in the study. Of these, 74.8% were males, with mean age 55.03 ± 13.57 years, and mean duration from symptom onset being 6.69 ± 6.3 days. A total of 82.4% had WHO severe category COVID-19, with 46.56% having severe hypoxia at presentation and 61.8% of them having some comorbidity. Spearman rank correlation coefficient of IL-6 with D-dimer was 0.203, with LDH was -0.005, with ferritin was 0.3, and with uric acid was 0.123. A total of 11 patients received Tocilizumab at a mean duration from symptom onset of 18.09 days, and 100% mortality was observed. Deaths were reported more in the group with IL-6 ≥ 40 pg/mL (57.1% vs. 40.2%, = 0.06). ICU admissions and ventilator requirement were higher in the IL-6 ≥ 40 pg/mL group (95.9% vs. 91.4%, = 0.32 and 55.1% vs. 37.8%, = 0.05). The study showed that IL-6 can be used as a possible "thrombotic cytokine marker". Higher values of IL-6 (≥40 pg/mL) are associated with more deaths, ICU admissions, and ventilator requirement.
自2019年12月出现以来，新冠病毒病（COVID-19）在全球范围内造成了毁灭性影响。白细胞介素-6（IL-6）是COVID-19治疗中使用的主要标志物之一。我们进行了一项纵向研究，以调查IL-6在COVID-19相关细胞因子风暴的诊断、治疗和预后中的作用。纳入了2020年3月至12月在瑞诗凯诗全印医学科学研究所（AIIMS Rishikesh）住院的COVID-19患者。排除入院时无基线IL-6值且无临床数据的患者。这些患者的临床和实验室数据从电子医院门户网站收集，并录入Excel表格。分析其与其他炎症标志物的相关性，并使用MS Excel 2010和SPSS软件评估结果。该研究共纳入131例患者。其中，74.8%为男性，平均年龄55.03±13.57岁，症状出现后的平均病程为6.69±6.3天。共有82.4%的患者属于世界卫生组织（WHO）定义的重症COVID-19，46.56%的患者就诊时存在严重缺氧，61.8%的患者患有某种合并症。IL-6与D-二聚体的Spearman等级相关系数为0.203，与乳酸脱氢酶（LDH）为-0.005，与铁蛋白为0.3，与尿酸为0.123。共有11例患者在症状出现后的平均病程18.09天时接受了托珠单抗治疗，观察到的死亡率为100%。IL-6≥40 pg/mL组的死亡报告更多（57.1%对40.2%，P = 0.06）。IL-6≥40 pg/mL组的重症监护病房（ICU）入院率和呼吸机需求更高（95.9%对91.4%，P = 0.32；55.1%对37.8%，P = 0.05）。该研究表明，IL-6可作为一种可能的“血栓形成细胞因子标志物”。较高的IL-6值（≥40 pg/mL）与更多的死亡、ICU入院和呼吸机需求相关。
