Interleukin‐6 in Covid‐19: A systematic review and meta‐analysis
By E. Coomes, H. Haghbayan. medRxiv, 2020
795 citations recorded by the source corpus.
Coronaviruses may activate dysregulated host immune responses. As exploratory studies have suggested that interleukin‐6 (IL‐6) levels are elevated in cases of complicated Covid‐19, we undertook a systematic review and meta‐analysis to assess the evidence in this field. We systematically searched MEDLINE and EMBASE for studies investigating the immunological response in Covid‐19; additional grey literature searches were undertaken. Study selection and data abstraction was undertaken independently by two authors. Meta‐analysis was undertaken using random effects models to compute ratios of means with 95% confidence intervals (95%CIs). Eight published studies and two preprints (n = 1798) were eligible for inclusion. Meta‐analysis of mean IL‐6 concentrations demonstrated 2.9‐fold higher levels in patients with complicated Covid‐19 compared with patients with noncomplicated disease (six studies; n = 1302; 95%CI, 1.17‐7.19; I2 = 100%). Consistent results were found in sensitivity analyses exclusively restricted to studies comparing patients requiring ICU admission vs no ICU admission (two studies; n = 540; ratio of means = 3.24; 95%CI, 2.54‐4.14; P < .001; I2 = 87%). Nine of ten studies were assessed to have at least moderate risk of bias. In patients with Covid‐19, IL‐6 levels are significantly elevated and associated with adverse clinical outcomes. Inhibition of IL‐6 may be a novel target for therapeutics for the management of dysregulated host responses in patients with Covid‐19 and high‐quality studies of intervention in this field are urgently required.
Subfields: Infectious Diseases, Neurology
View Paper: https://www.semanticscholar.org/paper/5a1cfee3acc1c0c1863e32f155417f69b111700e
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Citations in the corpus
- Recognizing COVID-19–related myocarditis: The possible pathophysiology and proposed guideline for diagnosis and management (2020, neutral): “Substantial evidence now suggests an increase in serum IL-6 in COVID-19 patients, especially in those with severe presentations.(37) Therefore, it is plausible that SARS-CoV-2 infection precipitates arrhythmias in patients with a genetic predisposition.”
- Immune Response, Inflammation, and the Clinical Spectrum of COVID-19 (2020, methodology): “(112) performed a meta-analysis of 16 papers, that included 10,798 Chinese patients, in order to test the evidence that IL-6 levels correlate with COVID-19 severity, and the effectiveness of treatment with Tocilizumab, a humanized monoclonal antibody against IL-6 receptor.”
- Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions (2020, neutral): “plicated COVID-19 compared to patients with non-complicated disease [119].”