Interleukin-6 Is a Biomarker for the Development of Fatal Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia

Hyper-inflammatory responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a major cause of disease severity and death. Predictive prognosis biomarkers to guide therapeutics are critically lacking. Several studies have indicated a "cytokine storm" with the rel...

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Bibliographic Details
Published in:	Frontiers in immunology 2021-02, Vol.12, p.613422-613422
Main Authors:	Santa Cruz, André, Mendes-Frias, Ana, Oliveira, Ana Isabel, Dias, Luís, Matos, Ana Rita, Carvalho, Alexandre, Capela, Carlos, Pedrosa, Jorge, Castro, António Gil, Silvestre, Ricardo
Format:	Article
Language:	eng
Subjects:	Adult Age Factors Aged Aged, 80 and over biomarker Biomarkers - blood C-Reactive Protein - metabolism COVID-19 COVID-19 - blood COVID-19 - mortality Cytokine Release Syndrome - blood Cytokine Release Syndrome - mortality fatal pneumonia Female Follow-Up Studies Humans IL-6 Immunology Interleukin-6 - blood Male Middle Aged Oxygen - blood SARS-CoV-2 SARS-CoV-2 - metabolism
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Summary:	Hyper-inflammatory responses induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a major cause of disease severity and death. Predictive prognosis biomarkers to guide therapeutics are critically lacking. Several studies have indicated a "cytokine storm" with the release of interleukin-1 (IL-1), IL-6, and IL-8, along with tumor necrosis factor alpha (TNFα) and other inflammatory mediators. Here, we proposed to assess the relationship between IL-6 and outcomes of patients with coronavirus disease 2019 (COVID-19). Our cohort consisted of 46 adult patients with PCR-proven SARS-CoV-2 infection admitted in a COVID-19 ward of the Hospital de Braga (HB) from April 7 to May 7, 2020, whose IL-6 levels were followed over time. We found that IL-6 levels were significantly different between the disease stages. Also, we found a significant negative correlation between IL-6 levels during stages IIb and III, peripheral oxygen saturation (SpO ), and partial pressure of oxygen in arterial blood (PaO ), showing that IL-6 correlates with respiratory failure. Compared to the inflammatory markers available in the clinic routine, we found a positive correlation between IL-6 and C-reactive protein (CRP). However, when we assessed the predictive value of these two markers, IL-6 behaves as a better predictor of disease progression. In a binary logistic regression, IL-6 level was the most significant predictor of the non-survivors group, when compared to age and CRP. Herein, we present IL-6 as a relevant tool for prognostic evaluation, mainly as a predictor of outcome.
ISSN:	1664-3224 1664-3224