IL-6 and PCR, possible predictors of CoViD-19 pneumonia

ABSTRACT

Background: Many CoViD-19-infected patients may die due to an over-response of the immune system (IS) characterized by the abnormal release of circulating cytokines. The SARS-CoV-2 virus binds to alveolar cells, activating the IS, with the release of numerous cytokines, including interleukin 6 (IL-6), which is responsible for the increase of the reactive C protein (PCR). PCR is useful for assessing the trend of acute inflammation in patients with CoViD-19 pneumonia, while the dosage of IL-6 is not routine. Materials and Methods: In 35 consecutive patients coming from the Emergency Room and then admitted to our division, we dosed IL-6 and PCR at the entrance (T0) and after 5 days (T5), to understand if the combination of the 2 values could be more predictive of the course of the disease. The degree of clinical stability was assessed using the Modified Early Warning Score (Mews). Results: At T0 the subjects with MEWS score 0 were 9, score 1 were 11, score 2 were 12, 1 score 3, 1 score 4. The average value of IL-6 of the subjects to T0 was 52.6 (range 16-150), with higher values in subjects with higher MEWS, from score 0 to 3 respectively 16.9, 46.8, 76.4, 150.0. Values of IL-6 at T5 remain increasing as the MEWS score increases, with average values=24.3 for MEWS 0-2 and 138.7 for MEWS 3-5 (p=0.07). Similar trends presented PCR values with average values of 41.0 for MEWS 0-2 and 144.4 for MEWS 3-5 (p<0.05). Conclusions: Preliminary data from our study, limited by the small sample, suggest that high values of IL-6 and PCR are present in patients with more severe clinical scores, and should be confirmed by larger-scale studies.