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
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...
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e085971.full |
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| author | Vuong Minh Nong Vinh Duc Nguyen Son Ngoc Do Co Xuan Dao My Ha Nguyen Dung Thi Pham Chi Van Nguyen Chinh Quoc Luong Dung Tien Nguyen Quynh Thi Pham Nhung Hong Khuat Giap Van Vu Dat Tien Hoang Anh Diep Nguyen Phuong Minh Nguyen Duong Dai Cao Dung Thuy Pham Thai Quoc Nguyen Dung Tuan Dang Dat Tuan Nguyen Thuan Quang Le Viet Khoi Nguyen Hung Duc Ngo Dung Van Nguyen Thach The Pham Nguyen Trung Nguyen Tan Dang Do Nhung Thi Huynh Nga Thu Phan Cuong Duy Nguyen Khoi Hong Vo Thom Thi Vu Cuong Duy Do Tuan Quoc Dang Tan Cong Nguyen |
| author_facet | Vuong Minh Nong Vinh Duc Nguyen Son Ngoc Do Co Xuan Dao My Ha Nguyen Dung Thi Pham Chi Van Nguyen Chinh Quoc Luong Dung Tien Nguyen Quynh Thi Pham Nhung Hong Khuat Giap Van Vu Dat Tien Hoang Anh Diep Nguyen Phuong Minh Nguyen Duong Dai Cao Dung Thuy Pham Thai Quoc Nguyen Dung Tuan Dang Dat Tuan Nguyen Thuan Quang Le Viet Khoi Nguyen Hung Duc Ngo Dung Van Nguyen Thach The Pham Nguyen Trung Nguyen Tan Dang Do Nhung Thi Huynh Nga Thu Phan Cuong Duy Nguyen Khoi Hong Vo Thom Thi Vu Cuong Duy Do Tuan Quoc Dang Tan Cong Nguyen |
| author_sort | Vuong Minh Nong |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-f605634c676e4d4db103e9b4a34d03ae |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-f605634c676e4d4db103e9b4a34d03ae2024-12-17T10:10:10ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-085971Predictive 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 studyVuong Minh Nong0Vinh Duc Nguyen1Son Ngoc Do2Co Xuan Dao3My Ha Nguyen4Dung Thi Pham5Chi Van Nguyen6Chinh Quoc Luong7Dung Tien Nguyen8Quynh Thi Pham9Nhung Hong Khuat10Giap Van Vu11Dat Tien Hoang12Anh Diep Nguyen13Phuong Minh Nguyen14Duong Dai Cao15Dung Thuy Pham16Thai Quoc Nguyen17Dung Tuan Dang18Dat Tuan Nguyen19Thuan Quang Le20Viet Khoi Nguyen21Hung Duc Ngo22Dung Van Nguyen23Thach The Pham24Nguyen Trung Nguyen25Tan Dang Do26Nhung Thi Huynh27Nga Thu Phan28Cuong Duy Nguyen29Khoi Hong Vo30Thom Thi Vu31Cuong Duy Do32Tuan Quoc Dang33Tan Cong Nguyen3413 Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam3 Department of Emergency and Critical Care Medicine, Faculty of Medicine, VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam5 Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam6 Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam8 Intensive Care Unit, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam24 Department of Internal Medicine, Hanoi Medical University, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam9 Intensive Care Unit, Hanoi Heart Hospital, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam13 Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam15 Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam1 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam13 Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam14 Poison Control Center, Bach Mai Hospital, Hanoi, Viet Nam15 Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam17 Department of Internal Medicine, Faculty of Medicine, VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam5 Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam18 Department of Emergency and Critical Care Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam19 Department of Neuro Intensive Care and Emergency Neurology, Neurology Center, Bach Mai Hospital, Hanoi, Viet Nam22 Department of Basic Medical Sciences, VNU University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam13 Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet NamObjectives 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.https://bmjopen.bmj.com/content/14/12/e085971.full |
| spellingShingle | Vuong Minh Nong Vinh Duc Nguyen Son Ngoc Do Co Xuan Dao My Ha Nguyen Dung Thi Pham Chi Van Nguyen Chinh Quoc Luong Dung Tien Nguyen Quynh Thi Pham Nhung Hong Khuat Giap Van Vu Dat Tien Hoang Anh Diep Nguyen Phuong Minh Nguyen Duong Dai Cao Dung Thuy Pham Thai Quoc Nguyen Dung Tuan Dang Dat Tuan Nguyen Thuan Quang Le Viet Khoi Nguyen Hung Duc Ngo Dung Van Nguyen Thach The Pham Nguyen Trung Nguyen Tan Dang Do Nhung Thi Huynh Nga Thu Phan Cuong Duy Nguyen Khoi Hong Vo Thom Thi Vu Cuong Duy Do Tuan Quoc Dang Tan Cong Nguyen 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 BMJ Open |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://bmjopen.bmj.com/content/14/12/e085971.full |
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