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Elevated levels of IL-6 in serum of COVID-19 patients after Tocilizumab treatment
Scandinavian Journal of Immunology ; 95(6), 2022.
Article in English | EMBASE | ID: covidwho-1968192
ABSTRACT
The COVID-19 pandemic has had a dramatic effect on the quality of life worldwide. It is caused by the SARS-CoV-2 virus and the main symptoms include myalgia, headache, and non-productive cough. Tocilizumab (TCZ) is a monoclonal antibody antagonist for the Interleukin-6 (IL-6) receptor. TCZ has shown significant efficacy in patients with severe COVID-19 because of the upregulation of IL-6 in their serum that has a correlation to severe disease and mortality. Here, we show how levels of IL-6 in serum of TCZ treated COVID-19 patients in the intensive care unit (ICU) is elevated in response to the TCZ treatment. Five COVID-19 patients that were administered TCZ in the ICU had serum samples taken at least two timepoints, before and after TCZ administration. Serum cytokine and antibody levels were analysed by multiplex. The study was approved by The National Bioethics Committee (VSN-20-169) and the Data Protection Authority. As expected, all ICU patients were in cytokine storm with significantly high levels of various inflammatory mediators including IL-6 (ranging from 4-196 pg/ml) before TCZ administration. Interestingly, despite of overall clinical improvements TCZ administration led to a significant surge of IL-6 levels, resulting in a 213-fold increase after treatment (range from 1940-9067 pg/ml). In contrast to IL-6 none of the other inflammatory biomarkers had the same pattern. However, IL-10 was downregulated in 4/5 individuals. Finally, all patients demonstrated normal antibody response in addition to high IgA levels against receptor binding domain and spike 1. These findings demonstrate that receptor blockage of cytokines can lead to a significant surge of its corresponding cytokine with unclear, but potentially important clinical significance.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Scandinavian Journal of Immunology Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Scandinavian Journal of Immunology Year: 2022 Document Type: Article