IL-6 level association with outcome.

ObjectiveThe 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.MethodsWe included all critically ill patients diagnosed with COVID-19 managed in ICU. IL6 was measured during the first 24 hours of hospitalization.Results71 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 ConclusionsIL-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.

研究目的：本研究旨在探讨白细胞介素6（Interleukin 6, IL6）在预测重症新型冠状病毒肺炎（Corona Virus Disease 2019, COVID-19）患者预后中的作用。
研究设计：前瞻性观察队列研究。
研究地点：2020年9月至12月期间，阿卜杜勒拉赫曼·马米教学医院的20床位呼吸内科重症监护病房（Intensive Care Unit, ICU）。
研究方法：纳入所有在重症监护病房接受治疗的确诊重症COVID-19患者。于患者住院首24小时内检测其血清IL6水平。
研究结果：共纳入71例患者，平均年龄为64±12岁，性别比例为22。多数患者合并基础疾病，包括高血压（n=32，45%）、肥胖（n=32，45%）及糖尿病（n=29，41%）。所有患者均接受地塞米松6 mg 每日两次的治疗方案。30例（42%）患者需接受高流量氧疗；59例（83%）接受无创通气，中位通气时长为2[1–5]天。44例（62%）患者需接受有创机械通气，中位启动延迟时间为1[0–4]天。重症监护病房中位住院时长为11[7–17]天，总体死亡率为61%。患者住院首24小时的血清IL6中位水平为34.4[12.5–106] pg/ml。多因素分析显示，IL-6≥20 pg/ml、肌酸磷酸激酶（Creatine Phosphokinase, CPK）
研究结论：IL-6是重症COVID-19患者的强效死亡率预测因子。鉴于IL-6拮抗剂成本高昂，本研究结果可帮助临床医师甄别适合接受此类治疗的患者。