Interleukin-6 and severe COVID-19: a systematic review and meta-analysis.

IF 2.2 4区医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY

European cytokine network Pub Date : 2020-06-01 DOI:10.1684/ecn.2020.0448

Helia Mojtabavi, Amene Saghazadeh, Nima Rezaei

{"title":"Interleukin-6 and severe COVID-19: a systematic review and meta-analysis.","authors":"Helia Mojtabavi, Amene Saghazadeh, Nima Rezaei","doi":"10.1684/ecn.2020.0448","DOIUrl":null,"url":null,"abstract":"Background: Evidence links COVID-19 severity to hyper-inflammation. Treatment with tocilizumab, a monoclonal antibody directed against the interleukin-6 (IL-6) receptor, was shown to lead to clinical improvement in patients with severe COVID-19. We, therefore, performed the present systematic review and meta-analysis to investigate whether the circulating levels of IL-6 is a reliable indicator of disease severity among patients affected with COVID-19.Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar on April 19, 2020.Results: Eleven studies provided data of IL-6 levels in patients with severe to critical COVID-19 (severe) and patients with mild to moderate COVID-19 (non-severe). The included studies were of moderate to high quality. The mean patients' age was 60.9 years, ranging from 45.2 to 76.7 years in the severe group and 46.8 years, ranging from 37.9 to 61 years, in the nonsevere group. Fifty-two percent were male in the severe group, as compared to 46% in the non-severe group. An overall random effects meta-analysis showed significantly higher serum levels of IL-6 in the severe group than in the non-severe group with a mean difference of +23.1 pg/mL (95% CI: 12.42-33.79) and the overall effect of 4.24 (P-value < 0.001). Meta-regressions showed that neither age nor sex significantly influenced the mean difference of IL-6 between the groups.Conclusions: Meta-analysis and meta-regression reveal a reliable relationship between IL-6 and COVID-19 severity, independent of age and sex. Future research is, however, required to assess the effect of BMI on the pattern of IL-6 production in patients with COVID-19. Also, there might be confounding factors that influence the relationship between IL-6 and COVID-19 severity and remain as yet unknown.","PeriodicalId":11749,"journal":{"name":"European cytokine network","volume":"31 2","pages":"44-49"},"PeriodicalIF":2.2000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530350/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European cytokine network","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1684/ecn.2020.0448","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Evidence links COVID-19 severity to hyper-inflammation. Treatment with tocilizumab, a monoclonal antibody directed against the interleukin-6 (IL-6) receptor, was shown to lead to clinical improvement in patients with severe COVID-19. We, therefore, performed the present systematic review and meta-analysis to investigate whether the circulating levels of IL-6 is a reliable indicator of disease severity among patients affected with COVID-19.

Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar on April 19, 2020.

Results: Eleven studies provided data of IL-6 levels in patients with severe to critical COVID-19 (severe) and patients with mild to moderate COVID-19 (non-severe). The included studies were of moderate to high quality. The mean patients' age was 60.9 years, ranging from 45.2 to 76.7 years in the severe group and 46.8 years, ranging from 37.9 to 61 years, in the nonsevere group. Fifty-two percent were male in the severe group, as compared to 46% in the non-severe group. An overall random effects meta-analysis showed significantly higher serum levels of IL-6 in the severe group than in the non-severe group with a mean difference of +23.1 pg/mL (95% CI: 12.42-33.79) and the overall effect of 4.24 (P-value < 0.001). Meta-regressions showed that neither age nor sex significantly influenced the mean difference of IL-6 between the groups.

Conclusions: Meta-analysis and meta-regression reveal a reliable relationship between IL-6 and COVID-19 severity, independent of age and sex. Future research is, however, required to assess the effect of BMI on the pattern of IL-6 production in patients with COVID-19. Also, there might be confounding factors that influence the relationship between IL-6 and COVID-19 severity and remain as yet unknown.

查看原文本刊更多论文

白细胞介素-6 和严重 COVID-19：系统回顾和荟萃分析。

背景：有证据表明，COVID-19 的严重程度与炎症亢进有关。托西珠单抗是一种针对白细胞介素-6（IL-6）受体的单克隆抗体，其治疗可改善严重 COVID-19 患者的临床症状。因此，我们进行了本系统综述和荟萃分析，研究循环中的IL-6水平是否是衡量COVID-19患者疾病严重程度的可靠指标：2020年4月19日，在PubMed、Scopus、Web of Science和Google Scholar上进行了系统检索：结果：11 项研究提供了重度至危重 COVID-19 患者（严重）和轻度至中度 COVID-19 患者（非严重）的 IL-6 水平数据。纳入的研究质量为中上等。重度组患者的平均年龄为 60.9 岁，从 45.2 岁到 76.7 岁不等；非重度组患者的平均年龄为 46.8 岁，从 37.9 岁到 61 岁不等。重度组中男性占 52%，而非重度组中男性占 46%。总体随机效应荟萃分析显示，重症组的血清 IL-6 水平明显高于非重症组，平均差异为 +23.1 pg/mL（95% CI：12.42-33.79），总体效应为 4.24（P 值结论）：元分析和元回归揭示了IL-6与COVID-19严重程度之间的可靠关系，与年龄和性别无关。然而，未来的研究需要评估 BMI 对 COVID-19 患者 IL-6 生成模式的影响。此外，可能还有一些混杂因素会影响 IL-6 与 COVID-19 严重程度之间的关系，这些因素目前仍不清楚。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European cytokine network 生物-免疫学

CiteScore

5.70

自引率

0.00%

发文量

审稿时长

6 months

期刊介绍： The journal that brings together all areas of work involving cytokines. European Cytokine Network is an electronic journal that publishes original articles and abstracts every quarter to provide an essential bridge between researchers and clinicians with an interest in this cutting-edge field. The journal has become a must-read for specialists in the field thanks to its swift publication and international circulation. The journal is referenced in several databases, including Medline, which is testament to its scientific quality.