Faculty of Medicine, Medical Intensive Care Unit, Abderrahmen Mami Hospital, University of Tunis EI Manar, Ariana, Tunisia.
Research Unit for Respiratory Failure and Mechanical Ventilation UR22SP01, Ministry of Higher Education and Scientific Research, Tunis, Tunisia.
PLoS One. 2023 Mar 1;18(3):e0279935. doi: 10.1371/journal.pone.0279935. eCollection 2023.
The aim of this study is to explore the role of IL6 in predicting outcome in critically ill COVID-19 patients. Design Prospective observational cohort study. Setting 20-bed respiratory medical intensive care unit of Abderrahmen Mami Teaching Hospital between September and December 2020.
We included all critically ill patients diagnosed with COVID-19 managed in ICU. IL6 was measured during the first 24 hours of hospitalization.
71 patients were included with mean age of 64 ± 12 years, gender ratio of 22. Most patients had comorbidities, including hypertension (n = 32, 45%), obesity (n = 32, 45%) and diabetes (n = 29, 41%). Dexamethasone 6 mg twice a day was initiated as treatment for all patients. Thirty patients (42%) needed high flow oxygenation; 59 (83%) underwent non-invasive ventilation for a median duration 2 [1-5] days. Invasive mechanical ventilation was required in 44 (62%) patients with a median initiation delay of 1 [0-4] days. Median ICU length of stay was 11 [7-17] days and overall mortality was 61%. During the first 24 hours, median IL6 was 34.4 [12.5-106] pg/ml. Multivariate analysis shows that IL-6 ≥ 20 pg/ml, CPK < 107 UI/L, AST < 30 UI/L and invasive ventilation requirement are independent risk factors for mortality.
IL-6 is a strong mortality predictor among critically ill COVID19 patients. Since IL-6 antagonist agents are costly, this finding may help physicians to consider patients who should benefit from that treatment.
本研究旨在探讨白细胞介素 6（IL-6）在预测 COVID-19 危重症患者预后中的作用。
前瞻性观察队列研究。
2020 年 9 月至 12 月期间，阿卜杜勒马米教学医院的 20 张床位呼吸内科重症监护病房。
我们纳入了所有在 ICU 中诊断为 COVID-19 的危重症患者。在住院的头 24 小时内测量了 IL-6。
共纳入 71 例患者，平均年龄为 64±12 岁，男女比例为 22:1。大多数患者有合并症，包括高血压（n=32，45%）、肥胖（n=32，45%）和糖尿病（n=29，41%）。所有患者均接受了每日两次 6mg 地塞米松治疗。30 例（42%）患者需要高流量氧疗；59 例（83%）患者接受了中位持续时间为 2[1-5]天的无创通气。44 例（62%）患者需要有创机械通气，中位启动延迟时间为 1[0-4]天。中位 ICU 住院时间为 11[7-17]天，总死亡率为 61%。在最初的 24 小时内，IL-6 的中位数为 34.4[12.5-106]pg/ml。多变量分析显示，IL-6≥20pg/ml、CPK<107UI/L、AST<30UI/L 和有创通气需求是死亡的独立危险因素。
IL-6 是 COVID19 危重症患者死亡的一个强有力的预测因素。由于白细胞介素 6 拮抗剂药物昂贵，这一发现可能有助于医生考虑哪些患者可能从该治疗中受益。
