IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study.

Autor: Galván-Román, José María, Rodríguez-García, Sebastián C., Roy-Vallejo, Emilia, Marcos-Jiménez, Ana, Sánchez-Alonso, Santiago, Fernández-Díaz, Carlos, Alcaraz-Serna, Ana, Mateu-Albero, Tamara, Rodríguez-Cortes, Pablo, Sánchez-Cerrillo, Ildefonso, Esparcia, Laura, Martínez-Fleta, Pedro, López-Sanz, Celia, Gabrie, Ligia, del Campo Guerola, Luciana, Suárez-Fernández, Carmen, Ancochea, Julio, Canabal, Alfonso, Albert, Patricia, Rodríguez-Serrano, Diego A.
Zdroj: Journal of Allergy & Clinical Immunology; Jan2021, Vol. 147 Issue 1, p72-72, 1p
Abstrakt: Patients with coronavirus disaese 2019 (COVID-19) can develop a cytokine release syndrome that eventually leads to acute respiratory distress syndrome requiring invasive mechanical ventilation (IMV). Because IL-6 is a relevant cytokine in acute respiratory distress syndrome, the blockade of its receptor with tocilizumab (TCZ) could reduce mortality and/or morbidity in severe COVID-19. We sought to determine whether baseline IL-6 serum levels can predict the need for IMV and the response to TCZ. A retrospective observational study was performed in hospitalized patients diagnosed with COVID-19. Clinical information and laboratory findings, including IL-6 levels, were collected approximately 3 and 9 days after admission to be matched with preadministration and postadministration of TCZ. Multivariable logistic and linear regressions and survival analysis were performed depending on outcomes: need for IMV, evolution of arterial oxygen tension/fraction of inspired oxygen ratio, or mortality. One hundred forty-six patients were studied, predominantly males (66%); median age was 63 years. Forty-four patients (30%) required IMV, and 58 patients (40%) received treatment with TCZ. IL-6 levels greater than 30 pg/mL was the best predictor for IMV (odds ratio, 7.1; P <.001). Early administration of TCZ was associated with improvement in oxygenation (arterial oxygen tension/fraction of inspired oxygen ratio) in patients with high IL-6 (P =.048). Patients with high IL-6 not treated with TCZ showed high mortality (hazard ratio, 4.6; P =.003), as well as those with low IL-6 treated with TCZ (hazard ratio, 3.6; P =.016). No relevant serious adverse events were observed in TCZ-treated patients. Baseline IL-6 greater than 30 pg/mL predicts IMV requirement in patients with COVID-19 and contributes to establish an adequate indication for TCZ administration. [ABSTRACT FROM AUTHOR]
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