Interleukin-6 and C-reactive Protein on Admission as Predictor of Mortality in Severe COVID-19 Patients: A Retrospective Cohort Study

Rahayu Rahayu; Winarto Winarto; Taufiqurrachman Nasihun

doi:10.3889/oamjms.2022.7968

Authors

Rahayu Rahayu Master of Biomedical Sciences, Faculty of Medicine, Universitas Islam Sultan Agung, Central Java, Indonesia https://orcid.org/0000-0002-5185-7309
Winarto Winarto Department of Microbiology, Faculty of Medicine, Gunung Jati Swadaya University, Cirebon, West Java, Indonesia
Taufiqurrachman Nasihun Department of Biochemistry and Andrology and Postgraduate Biomedical Science, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.7968

Keywords:

Interleukin-6, C-reactive protein, Predictor of Mortality

Abstract

Predictors of mortality, an important factor to guide management in COVID-19 patients, have not been fully understood. The common laboratory test for assessing severity in COVID-19 patients include Interleukin-6 (IL-6) and C-Reactive Protein (CRP). The aims of this study were determine the relationship between the two inflammatory biomarkers and mortality as well as their cut-off values in severe COVID-19 patients. We retrospectively analyzed 80 confirmed patients with severe COVID-19 admitted to an intensive care unit of a secondary hospital in Indonesia between August and December 2020. They were analyzed for baseline clinical and laboratory findings at admission and during the disease. The primary outcome was mortality within 14 days from admission. CRP and IL-6 levels were evaluated as prognostic factors for outcome using the ROC curve. A total of 80 confirmed patients consisting of 53 (71.25%) survivors, and 23 (28.75%) non-survivors. Mortality was weakly correlated with levels of IL-6 (r = 0.249) and CRP (r = 0.247). The IL-6 cut-off was 101.64 pg/ml (AUROC 0.658 (95% CI 0.529 – 0.787); p = 0.028). The CRP cut-off was 46.45 mg/L (AUROC 0.659 (95% CI 0.532 – 0.786); p = 0.027). Levels of IL-6 and CRP at the first day of admission were weak predictors of mortality in severe COVID-19 patients.

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