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Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19.

ABSTRACT: Background:Interleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients have not been fully elucidated. Objective:To validate whether IL-6 levels are associated with disease severity and mortality and to investigate whether dynamic changes in IL-6 levels might be a predictive factor for lung injury in COVID-19 patients. Methods:This retrospective, single-center study included 728 adult COVID-19 patients and used data extracted from electronic medical records for analyses. Results:The mortality rate was higher in the elevated IL-6 group than in the normal IL-6 group (0.16 vs 5%). Cox proportional hazards and logistic regression analyses for survival (adjusted hazard ratio, 10.39; 95% confidence interval [CI], 1.09-99.23; p = 0.042) and disease severity (adjusted odds ratio, 3.56; 95% CI, 2.06-6.19; p < 0.001) revealed similar trends. Curve-fitting analyses indicated that patient computed tomography (CT) scores peaked on days 22 and 24. An initial decline in IL-6 levels on day 16 was followed by resurgence to a peak, nearly in tandem with the CT scores. Conclusion:Increased IL-6 level may be an independent risk factor for disease severity and in-hospital mortality and dynamic IL-6 changes may serve as a potential predictor for lung injury in Chinese COVID-19 patients. These findings may guide future treatment of COVID-19 patients.

SUBMITTER: Liu Z

PROVIDER: S-EPMC7379481 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19.

Liu Zeming Z Li Jinpeng J Chen Danyang D Gao Rongfen R Zeng Wen W Chen Sichao S Huang Yihui Y Huang Jianglong J Long Wei W Li Man M Guo Liang L Wang Xinghuan X Wu Xiaohui X

Frontiers in pharmacology 20200717

<h4>Background</h4>Interleukin-6 (IL-6), a proinflammatory cytokine, has been reported to be associated with disease severity and mortality in patients with coronavirus disease 2019 (COVID-19). Yet, dynamic changes in IL-6 levels and their prognostic value as an indicator of lung injury in COVID-19 patients have not been fully elucidated.<h4>Objective</h4>To validate whether IL-6 levels are associated with disease severity and mortality and to investigate whether dynamic changes in IL-6 levels m ...[more]

PMID: 32765283

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Project description:COVID-19 pandemic has posed serious risk of contagion to humans. There is a need to find reliable non-contact tests like vocal correlates of COVID-19 infection. Thirty-six Asian ethnic volunteers 16 (8M & 8F) infected subjects and 20 (10M &10F) non-infected controls participated in this study by vocalizing vowels /a/, /e/, /i/, /o/, /u/. Voice correlates of 16 COVID-19 positive patients were compared during infection and after recovery with 20 non-infected controls. Compared to non-infected controls, significantly higher values of energy intensity for /o/ (p = 0.048); formant F1 for /o/ (p = 0.014); and formant F3 for /u/ (p = 0.032) were observed in male patients, while higher values of Jitter (local, abs) for /o/ (p = 0.021) and Jitter (ppq5) for /a/ (p = 0.014) were observed in female patients. However, formant F2 for /u/ (p = 0.018), mean pitch F0 for /e/, /i/ and /o/ (p = 0.033; 0.036; 0.047) decreased for female patients under infection. Compared to recovered conditions, HNR for /e/ (p = 0.014) was higher in male patients under infection, while Jitter (rap) for /a/ (p = 0.041); Jitter (ppq5) for /a/ (p = 0.032); Shimmer (local, dB) for /i/ (p = 0.024); Shimmer (apq5) for /u/ (p = 0.019); and formant F4 for vowel /o/ (p = 0.022) were higher in female patients under infection. However, HNR for /e/ (p = 0.041); and formant F1 for /o/ (p = 0.002) were lower in female patients compared to their recovered conditions. Obtained results support the hypothesis since changes in voice parameters were observed in the infected patients which can be correlated to a combination of acoustic measures like fundamental frequency, formant characteristics, HNR, and voice perturbations like jitter and shimmer for different vowels. Thus, voice analysis can be used for scanning and prognosis of COVID-19 infection. Based on the findings of this study, a mobile application can be developed to analyze human voice in real-time to detect COVID-19 symptoms for remedial measures and necessary action.

Project description:BackgroundSince December 2019, the outbreak of COVID-19 caused a large number of hospital admissions in China. Many patients with COVID-19 have symptoms of acute respiratory distress syndrome, even are in danger of death. This is the first study to evaluate dynamic changes of D-Dimer and Neutrophil-Lymphocyte Count Ratio (NLR) as a prognostic utility in patients with COVID-19 for clinical use.MethodsIn a retrospective study, we collected data from 349 hospitalized patients who diagnosed as the infection of the COVID-19 in Wuhan Pulmonary Hospital. We used ROC curves and Cox regression analysis to explore critical value (optimal cut-off point associated with Youden index) and prognostic role of dynamic changes of D-Dimer and NLR.ResultsThree hundred forty-nine participants were enrolled in this study and the mortality rate of the patients with laboratory diagnosed COVID-19 was 14.9%. The initial and peak value of D-Dimer and NLR in deceased patients were higher statistically compared with survivors (P < 0.001). There was a more significant upward trend of D-Dimer and NLR during hospitalization in the deceased patients, initial D-Dimer and NLR were lower than the peak tests (MD) -25.23, 95% CI: - 31.81- -18.64, P < 0.001; (MD) -43.73, 95% CI:-59.28- -31.17, P < 0.001. The test showed a stronger correlation between hospitalization days, PCT and peak D-Dimer than initial D-Dimer. The areas under the ROC curves of peak D-Dimer and peak NLR tests were higher than the initial tests (0.94(95%CI: 0.90-0.98) vs. 0.80 (95% CI: 0.73-0.87); 0.93 (95%CI:0.90-0.96) vs. 0.86 (95%CI:0.82-0.91). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR was 0.73 mg/L, 3.78 mg/L,7.13 and 14.31 respectively. 35 (10.03%) patients were intubated. In the intubated patients, initial and peak D-Dimer and NLR were much higher than non-intubated patients (P < 0.001). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR in prognosticate of intubation was 0.73 mg/L, 12.75 mg/L,7.28 and 27.55. The multivariable Cox regression analysis showed that age (HR 1.04, 95% CI 1.00-1.07, P = 0.01), the peak D-Dimer (HR 1.03, 95% CI 1.01-1.04, P < 0.001) were prognostic factors for COVID-19 patients' death.ConclusionsTo dynamically observe the ratio of D-Dimer and NLR was more valuable during the prognosis of COVID-19. The rising trend in D-Dimer and NLR, or the test results higher than the critical values may indicate a risk of death for participants with COVID-19.

Dataset Information

Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19.

Publications

Dynamic Interleukin-6 Level Changes as a Prognostic Indicator in Patients With COVID-19.

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