Interleukin-6: A Versatile Biomarker in the Clinical Chemistry Laboratory in the COVID-19 Era
Correspondence Address :
Dr. Surupa Basu,
11, Dr Biresh Guha Street, Kolkata, West Bengal, India.
E-mail: basusurupa@gmail.com
Introduction: Interleukin-6 (IL-6) is a proinflammatory cytokine released during the cytokine storm of sepsis and Coronavirus Disease-2019 (COVID-19). IL-6 has been extensively used as a biomarker in Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) and in the emerging novel paediatric disease called Paediatric Inflammatory Multisystem Syndrometemporarily associated with SARS-CoV-2 (PIMS-TS) or Multisystem Inflammatory Syndrome in Children (MIS-C). Additionally, IL-6 measurement is necessary to decide for several cytokine-blocking and cytokine-removal therapies and to determine treatment adequacy.
Aim: Evaluation of the performance of IL-6 in COVID-19, PIMSTS/MIS-C and in CytoSorb cytokine removal therapy in sepsis as a versatile biomarker in clinical chemistry laboratory.
Materials and Methods: The study was an exploratory descriptive study carried out between March 2019 and February 2021 for a period of 24 months. IL-6 (pg/mL) was measured on Roche e411 immunoassay platform using Electrochemiluminiscence Assays (ECLIA) in 15 adult patients. Biological reference interval of the parameter was <7 pg/mL.
Results: The results showed that IL-6 was increased significantly in non survivors compared to survivors with COVID-19 (p-value=0.0043). IL-6 levels (normal <7 pg/mL) were highly elevated in children with PIMS-TS {median 75.9 pg/mL (IQR: 47.3-223.4)} reflecting the intense inflammatory state of the novel paediatric condition. All PIMS-TS cases (n=13) survived. IL-6 levels were increased post CytoSorb therapy in sepsis patients who did not survive and declined in survivors. IL-6 serially measured during treatment helped to monitor therapeutic adequacy in prolonged sepsis case.
Conclusion: The various applications of automated IL-6 testing in the clinical chemistry laboratory reflects the versatility of the trending biomarker.
Coronavirus disease-2019, Cytokine removal therapy, Diagnostic marker, Multisystem inflammatory syndrome, Sepsis
10.7860/JCDR/2021/51061.15713
Date of Submission: Jun 25, 2021
Date of Peer Review: Aug 15, 2021
Date of Acceptance: Sep 28, 2021
Date of Publishing: Dec 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 28, 2021
• Manual Googling: Sep 27, 2021
• iThenticate Software: Oct 13, 2021 (13%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com