Correlation between the elevated level of interleukin-6 following actemra administration and the mortality rate of seven severe COVID-19 patients
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20241204Keywords:
IL-6, Actemra, COVID-19, MortalityAbstract
The escalation and involvement of Interleukin 6 (IL-6) in the pathogenesis of COVID-19 have been documented in numerous studies and are recognized as a diagnostic criterion, disease biomarker, and therapeutic objective. Our study aims to explore the correlation between the elevated level of IL-6 following actemra administration and the mortality rate of seven severe COVID-19 patients who were admitted to the special care department of Ardabil city hospital. In this case-series study, 7 patients with severe COVID-19 were admitted to the special care department of Ardabil city hospital were included in the study. Venous blood samples (3 cc) were taken in admission and after actemra injection. The demographic characteristics of the patients, including age, sex, duration of hospitalization, need for intubation, BMI, and interleukin 6 levels, were recorded in a checklist. The patients were then monitored for their clinical course, disease outcome, and complications. The mean IL-6 before and after actemra was 413.57±138.38 and 805.50±128.18, respectively and the difference was significant. After treatment by actemra, 71.4% of patients were discharged from hospital without mortality. Although elevated IL-6 levels have been associated with cytokine storms and unfavorable consequences in COVID-19 patients. This report indicates that high interleukin levels do not guarantee mortality. Young individuals without underlying conditions were ultimately discharged from the ICU despite severe inflammation, thanks to timely treatment and albeit with severe disability.
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References
Liu B, Li M, Zhou Z, Guan X, Xiang Y. Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)? J Autoimmunity. 2020;111:102452.
Coomes EA, Haghbayan H. Interleukin‐6 in COVID‐19: a systematic review and meta‐analysis. Rev Med Virol. 2020;30(6):1-9.
Chen LY, Hoiland RL, Stukas S, Wellington CL, Sekhon MS. Confronting the controversy: interleukin-6 and the COVID-19 cytokine storm syndrome. Eur Respiratory Soc. 2020.
Bruno E, Richardson MP, Consortium RC. Postictal generalized EEG suppression and postictal immobility: what do we know? Epileptic Disorders. 2020;22(3):245-51.
Ulhaq ZS, Soraya GV. Interleukin-6 as a potential biomarker of COVID-19 progression. Medecine et maladies infectieuses. 2020;50(4):382.
Abidi E, El Nekidy WS, Alefishat E, Rahman N, Petroianu GA, El-Lababidi R, et al. Tocilizumab and COVID-19: timing of administration and efficacy. Frontiers in Pharmacology. 2022;13:825749.
Wong CK, Lau KT, Au IC, Xiong X, Chung MS, Leung BY, et al. Initiation of tocilizumab or baricitinib were associated with comparable clinical outcomes among patients hospitalized with COVID-19 and treated with dexamethasone. Frontiers in Pharmacology. 2022;13:866441.
Klopfenstein T, Zayet S, Lohse A, Balblanc J-C, Badie J, Royer P-Y, et al. Tocilizumab therapy reduced intensive care unit admissions and/or mortality in COVID-19 patients. Medecine et maladies infectieuses. 2020;50(5):397-400.
Flisiak R, Flisiak-Jackiewicz M, Rzymski P, Zarębska-Michaluk D. Tocilizumab for the treatment of COVID-19. Expert Review of Anti-infective Therapy. 2023.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020;395(10229):1033-4.
Campochiaro C, Della-Torre E, Cavalli G, De Luca G, Ripa M, Boffini N, et al. Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study. Euro J Internal Med. 2020;76:43-9.
Mojtabavi H, Saghazadeh A, Rezaei N. Interleukin-6 and severe COVID-19: a systematic review and meta-analysis. European Cytokine Network. 2020;31(2):44-9.
Udomsinprasert W, Jittikoon J, Sangroongruangsri S, Chaikledkaew U. Circulating levels of interleukin-6 and interleukin-10, but not tumor necrosis factor-alpha, as potential biomarkers of severity and mortality for COVID-19: systematic review with meta-analysis. J Clin Immunol. 2021;41:11-22.
Shafieipour S, Rezaei Zadeh Rukerd M, Shamsizadeh Meymandi T, Sinaei R, Sarafzadeh F, Abu Saeedi H, et al. The Effect of Intravenous Tocilizumab Therapy on the Prognosis of Patients with COVID-19: A Case-Control Study. Iranian J Med Microbiol. 2023;17(2):243-50.
