Interleukin-6 as a Prognostic Factor of Severity in SARS-CoV-2 Infected Egyptian Patients

Abstract Background Coronavirus disease 2019 (COVID-19) was announced in early December 2019. The pandemic situation is declared. Patients diagnosed as severe or critical cases are prone to multiple organ dysfunction syndrome, acute respiratory distress syndrome and even death This study aimed to evaluate the role of biomarkers in estimating the severity and predicting the prognosis of COVID-19. Objectives This cohort retrospective and prospective analysis were carried out to evaluate the association between IL-6 and severe disease and mortality in COVID-19 disease. Patients and Methods An analytical cohort retrospective and prospective study, it was performed in Fever Military Hospital-Almaza-Cairo-Egypt in period between 1/11/2020 till 1/11/2021 including all confirmed cases presented by moderate or severe symptoms and signs of covid19 manifestations. Results 227 patients were included in this study, 72% of them were males and the mean age was 61years old. About 37% of patients needed ICU admission and 46% of all patients died. The median level of IL-6 after 5 days of admission time in patients who still alive was 290.2 while more than level in died patients was 415. In patients who had extra- pulmonary manifestations we found that the median level of IL-6 after 5 days of admission time was 405.5 while in patients without extra-pulmonary manifestations was 242.45 with significant association. The median level of IL-6 after 5 days of admission time in patients who needed ICU admission was 300.4 while in patients didn’t need ICU was 408.8 without significant association. Conclusion This study revealed that elevated IL-6 is significantly related to prolongation of hospital stay in COVID-19 patients and Severity of disease. Also, the occurrence of death among patients who had increased IL-6 in the time of admission was higher than patients with normal or lower serum levels of IL-6. There was a significant relation between elevated IL-6 and extrapulmonary manifestations.