tetano
Editor, Senior Moderator
BMJ Open
. 2024 Dec 9;14(12):e085971.
doi: 10.1136/bmjopen-2024-085971. 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
Chi Van Nguyen[SUP] 1 2 [/SUP], Chinh Quoc Luong[SUP] 1 2 3 [/SUP], Co Xuan Dao[SUP] 2 3 4 [/SUP], My Ha Nguyen[SUP] 5 [/SUP], Dung Thi Pham[SUP] 6 [/SUP], Nhung Hong Khuat[SUP] 2 7 [/SUP], Quynh Thi Pham[SUP] 2 8 [/SUP], Dat Tien Hoang[SUP] 2 4 [/SUP], Anh Diep Nguyen[SUP] 2 9 [/SUP], Phuong Minh Nguyen[SUP] 2 10 [/SUP], Duong Dai Cao[SUP] 2 11 [/SUP], Dung Thuy Pham[SUP] 2 12 [/SUP], Thai Quoc Nguyen[SUP] 13 [/SUP], Vuong Minh Nong[SUP] 13 [/SUP], Dung Tuan Dang[SUP] 1 3 [/SUP], Dat Tuan Nguyen[SUP] 1 2 3 [/SUP], Vinh Duc Nguyen[SUP] 1 [/SUP], Thuan Quang Le[SUP] 2 14 [/SUP], Viet Khoi Nguyen[SUP] 15 16 [/SUP], Hung Duc Ngo[SUP] 1 2 [/SUP], Dung Van Nguyen[SUP] 13 [/SUP], Thach The Pham[SUP] 2 3 4 [/SUP], Dung Tien Nguyen[SUP] 2 14 [/SUP], Nguyen Trung Nguyen[SUP] 2 3 14 [/SUP], Tan Dang Do[SUP] 15 [/SUP], Nhung Thi Huynh[SUP] 17 [/SUP], Nga Thu Phan[SUP] 5 [/SUP], Cuong Duy Nguyen[SUP] 18 [/SUP], Khoi Hong Vo[SUP] 19 20 21 [/SUP], Thom Thi Vu[SUP] 22 [/SUP], Cuong Duy Do[SUP] 13 23 [/SUP], Tuan Quoc Dang[SUP] 2 4 [/SUP], Giap Van Vu[SUP] 24 25 [/SUP], Tan Cong Nguyen[SUP] 26 3 4 [/SUP], Son Ngoc Do[SUP] 2 3 4 [/SUP]
Affiliations
Objectives: To investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam.
Design: A single-centre, cross-sectional study.
Setting: An Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam.
Participants: We 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 measures: The primary outcome was hospital all-cause mortality.
Results: Of 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.
Conclusions: This 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.
Keywords: ACCIDENT & EMERGENCY MEDICINE; Adult intensive & critical care; COVID-19; Mortality; SARS-CoV-2 Infection.
. 2024 Dec 9;14(12):e085971.
doi: 10.1136/bmjopen-2024-085971. 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
Chi Van Nguyen[SUP] 1 2 [/SUP], Chinh Quoc Luong[SUP] 1 2 3 [/SUP], Co Xuan Dao[SUP] 2 3 4 [/SUP], My Ha Nguyen[SUP] 5 [/SUP], Dung Thi Pham[SUP] 6 [/SUP], Nhung Hong Khuat[SUP] 2 7 [/SUP], Quynh Thi Pham[SUP] 2 8 [/SUP], Dat Tien Hoang[SUP] 2 4 [/SUP], Anh Diep Nguyen[SUP] 2 9 [/SUP], Phuong Minh Nguyen[SUP] 2 10 [/SUP], Duong Dai Cao[SUP] 2 11 [/SUP], Dung Thuy Pham[SUP] 2 12 [/SUP], Thai Quoc Nguyen[SUP] 13 [/SUP], Vuong Minh Nong[SUP] 13 [/SUP], Dung Tuan Dang[SUP] 1 3 [/SUP], Dat Tuan Nguyen[SUP] 1 2 3 [/SUP], Vinh Duc Nguyen[SUP] 1 [/SUP], Thuan Quang Le[SUP] 2 14 [/SUP], Viet Khoi Nguyen[SUP] 15 16 [/SUP], Hung Duc Ngo[SUP] 1 2 [/SUP], Dung Van Nguyen[SUP] 13 [/SUP], Thach The Pham[SUP] 2 3 4 [/SUP], Dung Tien Nguyen[SUP] 2 14 [/SUP], Nguyen Trung Nguyen[SUP] 2 3 14 [/SUP], Tan Dang Do[SUP] 15 [/SUP], Nhung Thi Huynh[SUP] 17 [/SUP], Nga Thu Phan[SUP] 5 [/SUP], Cuong Duy Nguyen[SUP] 18 [/SUP], Khoi Hong Vo[SUP] 19 20 21 [/SUP], Thom Thi Vu[SUP] 22 [/SUP], Cuong Duy Do[SUP] 13 23 [/SUP], Tuan Quoc Dang[SUP] 2 4 [/SUP], Giap Van Vu[SUP] 24 25 [/SUP], Tan Cong Nguyen[SUP] 26 3 4 [/SUP], Son Ngoc Do[SUP] 2 3 4 [/SUP]
Affiliations
- PMID: 39653572
- DOI: 10.1136/bmjopen-2024-085971
Objectives: To investigate the serum IL-6 levels and their rate of change in predicting the mortality of critically ill patients with COVID-19 in Vietnam.
Design: A single-centre, cross-sectional study.
Setting: An Intensive Care Centre for the Treatment of Critically Ill Patients with COVID-19 in Ho Chi Minh City, Vietnam.
Participants: We 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 measures: The primary outcome was hospital all-cause mortality.
Results: Of 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.
Conclusions: This 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.
Keywords: ACCIDENT & EMERGENCY MEDICINE; Adult intensive & critical care; COVID-19; Mortality; SARS-CoV-2 Infection.