Upregulated IL-6 Indicates a Poor COVID-19 Prognosis: A Call for Tocilizumab and Convalescent Plasma Treatment

Front Immunol. 2021 Mar 4:12:598799. doi: 10.3389/fimmu.2021.598799. eCollection 2021.

Abstract

A comprehensive understanding of the dynamic changes in interleukin-6 (IL-6) levels is essential for monitoring and treating patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). By analyzing the correlations between IL-6 levels and health conditions, underlying diseases, several key laboratory detection indices, and the prognosis of 1,473 patients with the coronavirus disease 2019 (COVID-19), the role of IL-6 during SARS-CoV-2 infection was demonstrated. Our results indicated that IL-6 levels were closely related to age, sex, body temperature, oxygen saturation (SpO2) of blood, and underlying diseases. As a stable indicator, the changes in IL-6 levels could indicate the inflammatory conditions during a viral infection. Two specific treatments, namely, tocilizumab and convalescent plasma therapy (CPT), decreased the level of IL-6 and relieved inflammation. CPT has an important role in the therapy for patients with critical COVID-19. We also found that patients with IL-6 levels, which were 30-fold higher than the normal level, had a poor prognosis compared to patients with lower levels of IL-6.

Keywords: COVID-19; CPT; IL6; SARS-CoV-2; discharge; tocilizumab.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • COVID-19 / blood
  • COVID-19 / epidemiology
  • COVID-19 / therapy*
  • COVID-19 Drug Treatment*
  • COVID-19 Serotherapy
  • Child
  • China / epidemiology
  • Female
  • Humans
  • Immunization, Passive
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Prognosis
  • Real-Time Polymerase Chain Reaction
  • SARS-CoV-2 / genetics*
  • Severity of Illness Index
  • Treatment Outcome
  • Up-Regulation*
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • IL6 protein, human
  • Interleukin-6
  • tocilizumab