Tags

Type your tag names separated by a space and hit enter

The association of interleukin-6 value, interleukin inhibitors, and outcomes of patients with COVID-19 in New York City.
J Med Virol. 2020 Jul 28 [Online ahead of print]JM

Abstract

Since cytokine release syndrome with elevation of interleukin-6 (IL-6) is considered to be associated with severe cases of coronavirus disease 2019 (COVID-19); IL-6 inhibitors, such as tocilizumab, are expected to be effective for its treatment. This was a retrospective study using a consecutive cohort of 224 patients hospitalized with COVID-19 in March 2020. Patients were divided into those admitted to the intensive care unit (ICU group) and those not (no ICU group), and clinical data including usage of tocilizumab were compared. Correlation between IL-6 value at admission and at peak, and tocilizumab use, as well as clinical outcomes were also investigated. The ICU group had higher rates of pre-existing comorbidities such as hypertension, diabetes, and coronary disease, and higher IL-6 than no ICU group (all P < .05). Age, peak IL-6, and peak d-dimer were significant predictors of in-hospital mortality (1.05 [1.01-1.09], P = .012; 1.001 [1.000-1.002], P = .002; 1.10 [1.03-1.18], P = .008). Receiver operating characteristics curve showed higher predictability of in-hospital mortality with IL-6 at peak than others (area under curve; IL-6 at peak: 0.875 [0.87-0.942], IL-6 at admission: 0.794 [0.699-0.889], d-dimer at peak 0.787 [0.690-0.883], d-dimer at admission 0.726 [0.625-0.827]). Incidence of fungal infections was significantly higher in patients who were given tocilizumab than those who were not (13.0% vs 1.1%, P < .001). Notably, tocilizumab did not affect in-hospital mortality after adjustment including IL-6 (odds ratio [95% confidential interval]: 1.00 [0.27-3.72, P = .998]). Age, peak IL-6, and peak d-dimer levels were significant predictors of in-hospital mortality. Tocilizumab did not decrease in-hospital mortality in our cohort.

Authors+Show Affiliations

Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York.Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York.Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York.Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York City, New York.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32720702

Citation

Maeda, Tetsuro, et al. "The Association of Interleukin-6 Value, Interleukin Inhibitors, and Outcomes of Patients With COVID-19 in New York City." Journal of Medical Virology, 2020.
Maeda T, Obata R, Rizk DO D, et al. The association of interleukin-6 value, interleukin inhibitors, and outcomes of patients with COVID-19 in New York City. J Med Virol. 2020.
Maeda, T., Obata, R., Rizk DO, D., & Kuno, T. (2020). The association of interleukin-6 value, interleukin inhibitors, and outcomes of patients with COVID-19 in New York City. Journal of Medical Virology. https://doi.org/10.1002/jmv.26365
Maeda T, et al. The Association of Interleukin-6 Value, Interleukin Inhibitors, and Outcomes of Patients With COVID-19 in New York City. J Med Virol. 2020 Jul 28; PubMed PMID: 32720702.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association of interleukin-6 value, interleukin inhibitors, and outcomes of patients with COVID-19 in New York City. AU - Maeda,Tetsuro, AU - Obata,Reiichiro, AU - Rizk DO,Dahlia, AU - Kuno,Toshiki, Y1 - 2020/07/28/ PY - 2020/06/01/received PY - 2020/06/26/accepted PY - 2020/7/29/pubmed PY - 2020/7/29/medline PY - 2020/7/29/entrez KW - COVID-19 KW - New York KW - intensive care unit KW - interleukin-6 KW - invasive mechanical ventilation KW - tocilizumab JF - Journal of medical virology JO - J. Med. Virol. N2 - Since cytokine release syndrome with elevation of interleukin-6 (IL-6) is considered to be associated with severe cases of coronavirus disease 2019 (COVID-19); IL-6 inhibitors, such as tocilizumab, are expected to be effective for its treatment. This was a retrospective study using a consecutive cohort of 224 patients hospitalized with COVID-19 in March 2020. Patients were divided into those admitted to the intensive care unit (ICU group) and those not (no ICU group), and clinical data including usage of tocilizumab were compared. Correlation between IL-6 value at admission and at peak, and tocilizumab use, as well as clinical outcomes were also investigated. The ICU group had higher rates of pre-existing comorbidities such as hypertension, diabetes, and coronary disease, and higher IL-6 than no ICU group (all P < .05). Age, peak IL-6, and peak d-dimer were significant predictors of in-hospital mortality (1.05 [1.01-1.09], P = .012; 1.001 [1.000-1.002], P = .002; 1.10 [1.03-1.18], P = .008). Receiver operating characteristics curve showed higher predictability of in-hospital mortality with IL-6 at peak than others (area under curve; IL-6 at peak: 0.875 [0.87-0.942], IL-6 at admission: 0.794 [0.699-0.889], d-dimer at peak 0.787 [0.690-0.883], d-dimer at admission 0.726 [0.625-0.827]). Incidence of fungal infections was significantly higher in patients who were given tocilizumab than those who were not (13.0% vs 1.1%, P < .001). Notably, tocilizumab did not affect in-hospital mortality after adjustment including IL-6 (odds ratio [95% confidential interval]: 1.00 [0.27-3.72, P = .998]). Age, peak IL-6, and peak d-dimer levels were significant predictors of in-hospital mortality. Tocilizumab did not decrease in-hospital mortality in our cohort. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/32720702/The_Association_of_Interleukin-6_value,_Interleukin_inhibitors_and_Outcomes_of_Patients_with_COVID-19_in_New_York_City L2 - https://doi.org/10.1002/jmv.26365 DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.