Clinical relevance of IL-6 and lactate levels within 24 hours of ICU admission of COVID–19 patients in predicting mortality rate
Abstract
Background & objective: Patients with COVID-19 have Acute Respiratory Distress Syndrome (ARDS) which progresses to lung edema and disorders of the liver, kidneys and heart associated with cytokine storms, which are the body's immune response to SARS-CoV-2. SARS-CoV-2 patients showed clinical neutrophilia, increased D-Dimer and increased IL-6. In addition, increased lactate dehydrogenase and increased aminotransferase are often found. This study aimed to analyze the clinical relevance of increased IL-6 and lactate in the first 24 hours of ICU-admission of COVID-19 patients in predicting mortality rate.
Methodology: This study was a retrospective cohort design. The study was conducted in the Intensive Care Unit (ICU) of Dr. Moewardi Surakarta Hospital. The study was conducted by tracing the medical records of COVID-19 patients treated in the ICU of Dr. Moewardi Surakarta Hospital during the period of March 1, 2020 to March 31, 2021 that met the admission criteria. The patient's mortality assessment is seen as the patient's condition for a maximum of 30 days after discharge from the hospital.
Results: Variables that meet the regression model are the lactate levels (OR = 3,143; P = 0.064) as well as the IL-6 levels (OR = 25.41; p<0.001). AUC score of 86.9% with significance of < 0.001. IL-6 levels and lactate levels in the study can be used as predictors of mortality rates with 95.7% sensitivity and 60% specificity. Lactate levels in COVID-19 cases in severe cases can be related to lung damage and tissue damage. Lactate levels have also been recognized as a marker of poor prognosis in patients with COVID-19. IL-6 as a predictor of mortality risk has been recognized and the administration of IL-6 inhibitors in COVID-19 patients may lower the risk of mortality.
Conclusion: Raised IL-6 and lactate levels in this study can be a predictor of the mortality rate of COVID-19 patients within 24 hours of ICU-admission.
Citation: Nugroho A, Hapsari PP, Santoso SB, Permana SA, Sitompul H. Clinical relevance of IL-6 and lactate within 24 hours of ICU-admission of COVID 19 patient in predicting mortality rate. Anaesth. pain intensive care 2022;26(5):689−694.
