Publication date: Dec 09, 2024
To investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam. A single-centre, cross-sectional study. An Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam. We included patients aged 18 years or older who were critically ill with COVID-19 and presented to the study centre from 30 July 2021 to 15 October 2021. We excluded patients who did not have serum IL-6 measurements between admission and the end of the first day. The primary outcome was hospital all-cause mortality. Of 90 patients, 41. 1% were men, the median age was 60. 5 years (Q1-Q3: 52. 0-71. 0), and 76. 7% of patients died in the hospital. Elevated IL-6 levels were observed on admission (41. 79 pg/mL; Q1-Q3: 20. 68-106. 27) and on the third day after admission (72. 00 pg/mL; Q1-Q3: 26. 98-186. 50), along with a significant rate of change in IL-6 during that period (839. 5%; SD: 2753. 2). While admission IL-6 level (areas under the receiver operator characteristic curve (AUROC): 0. 610 (95% CI: 0. 459 to 0. 761); cut-off value ≥15. 8 pg/mL) and rate of change in IL-6 on the third day of admission (AUROC: 0. 586 (95% CI: 0. 420 to 0. 751); cut-off value ≥-58. 7%) demonstrated poor discriminatory ability in predicting hospital mortality, the third day IL-6 rate of change from admission ≥-58. 7% (adjusted OR: 12. 812; 95% CI: 2. 104 to 78. 005) emerged as an independent predictor of hospital mortality. This study focused on a highly selected cohort of critically ill COVID-19 patients with a high IL-6 level and mortality rate. Despite the poor discriminatory value of admission IL-6 levels, the rate of change in IL-6 proved valuable in predicting mortality. To identify critically ill COVID-19 patients with the highest risk for mortality, monitoring the serial serum IL-6 measurements and observing the rate of change in serum IL-6 levels over time are needed.
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | critically ill |
| disease | MESH | COVID-19 |
| disease | MESH | pneumonia |
| disease | MESH | infections |
| disease | IDO | quality |
| drug | DRUGBANK | Coenzyme M |
| drug | DRUGBANK | Etoperidone |
| disease | MESH | emergency |
| disease | IDO | infection |
| disease | IDO | blood |
| drug | DRUGBANK | Corticorelin |
| disease | MESH | tics |
| drug | DRUGBANK | Oxygen |