Journal Article

Predictive validity of interleukin 6 (IL-6) for the mortality in critically ill COVID-19 patients with the B.1.617.2 (Delta) variant in Vietnam: a single-centre, cross-sectional study

Luong, Chinh Quoc, Nguyen, Viet Khoi, Do, Son Ngoc, Nguyen, Dat Tuan, Nguyen, Vinh Duc, Dao, Co Xuan, Do, Tan Dang, Cao, Duong Dai, Pham, Dung Thuy, Nguyen, My Ha, Nguyen, Nguyen Trung, Nguyen, Dung Tien, Nguyen, Tan Cong, Le, Thuan Quang, Phan, Nga Thu, Nguyen, Dung Van, Nguyen, Cuong Duy, Vu, Giap Van, Nguyen, Phuong Minh, Vo, Khoi Hong, Khuat, Nhung Hong, Nguyen, Anh Diep, Dang, Tuan Quoc, Nguyen, Thai Quoc, Pham, Dung Thi, Ngo, Hung Duc, Do, Cuong Duy, Hoang, Dat Tien, Huynh, Nhung Thi, Pham, Quynh Thi, Dang, Dung Tuan, Nong, Vuong Minh, Pham, Thach The, Nguyen, Chi Van, Vu, Thom Thi

2024

Overview

ObjectivesTo investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam.DesignA single-centre, cross-sectional study.SettingAn Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam.ParticipantsWe 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.Primary outcome measuresThe primary outcome was hospital all-cause mortality.ResultsOf 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.ConclusionsThis 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.

• Publisher: British Medical Journal Publishing Group,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: ACCIDENT & EMERGENCY MEDICINE / Adult intensive & critical care / Aged / Biomarkers - blood / Blood pressure / Cardiovascular disease / Comorbidity / COVID-19 / COVID-19 - blood / COVID-19 - mortality / Critical Illness - mortality / Cross-Sectional Studies / Cytokine storm / Data collection / Emergency medical care / Female / Global health / Hospital Mortality / Hospitals / Humans / Infections / Intensive Care / Intensive Care Units - statistics & numerical data / Interleukin-6 - blood / Male / Medicine / Middle Aged / Mortality / Original Research / Patients / Predictive Value of Tests / ROC Curve / SARS-CoV-2 / SARS-CoV-2 Infection / Severe acute respiratory syndrome coronavirus 2 / Vietnam