Dynamic changes in serum IL-6, IL-8, and IL-10 predict the outcome of ICU patients with severe COVID-19.

Li, Jia; Rong, Liu; Cui, Ran; Feng, Jiaqi; Jin, Yuyang; Chen, Xiaoxiang; Xu, Renying

BACKGROUND Biomarkers to prognosticate the outcomes and guide the treatment of patients with severe coronavirus disease 2019 (COVID-19) are currently required. We aimed to investigate whether the dynamic variation of cytokines was associated with the survival of patients admitted to the intensive care unit (ICU). METHODS A retrospective study was performed on 40 patients with COVID-19 admitted to the ICU in Wuhan, China. Demographic, clinical, and laboratory variables were collected, and serum cytokines were kinetically assessed. A multivariable-adjusted generalized linear regression model was used to analyze the differences in serum cytokine levels between survivors and non-survivors. RESULTS Among the 40 patients included, we found a positive correlation between multiple cytokines. Serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor alpha (TNFα) in non-survivors were consistently elevated compared to those in the survivors. Kinetic variations in IL-6, IL-8, and IL-10 were associated with a fatal outcome in patients with severe COVID-19, independent of sex, age, absolute lymphocyte count, direct bilirubin, hypertension, chronic obstructive pulmonary disease, and cancer as well as the use of glucocorticoids and tocilizumab. CONCLUSIONS Dynamic changes in serum IL-6, IL-8, and IL-10 levels were associated with survival in patients in the ICU, and could serve as a predictive biomarker to determine the therapeutic options for patients with severe COVID-19.