IL6 dosage in critical patients with COVID-19 and its relationship with mortality in the Adult Intensive Care Department of the Hospital de Clínicas. Paraguay

Abstract

Introduction: The new Coronavirus disease (COVID-19) is characterized by a serious affectation of the lower respiratory tract, producing in some patients an exaggerated inflammatory response, known as a cytokine storm that can often be fatal and irreversible, and that develops fundamentally in patients with associated comorbidities. The objective of this study was to characterize a population of critical patients with COVID-19 pneumonia, admitted to the Department of Intensive Care for Adults, Hospital de Clínicas of the Faculty of Medical Sciences, National University of Asunción, Paraguay between August 2020 and September 2021, in whom the levels of IL-6 were determined (at admission and day four), and the possible prognostic factors of mortality among the inflammatory markers measured on those two days of hospitalization were evaluated.

Materials and method: a cross-sectional analytical observational study was carried out. Data were obtained from the medical charts of hospitalized COVID-19 patients.

Results: 107 critically ill patients between 21 and 75 years of age (median 54 years), 56.1% male, were included. Patients with IL-6 greater than 40 pg/ml on the fourth day, as well as D-dimer and ferritin levels, were significantly associated with mortality in the bivariate analysis. In the multivariate analysis (by logistic regression) no independent mortality factor was identified. Overall mortality was 39.25%.

Conclusion: In COVID-19critical patients, the IL-6 dosage is increased on admission and its subsequent increase would indicate a progressive evolution of severity with a probability of an unfavorable outcome.