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BMC Infect Dis . Association of interleukin-6, ferritin, and lactate dehydrogenase with venous thromboembolism in COVID-19: a systematic review and

tetano

Editor, Senior Moderator
BMC Infect Dis


. 2024 Mar 16;24(1):324.
doi: 10.1186/s12879-024-09205-3. Association of interleukin-6, ferritin, and lactate dehydrogenase with venous thromboembolism in COVID-19: a systematic review and meta-analysis

Haiyu Liu[SUP] 1 [/SUP], Ningjing Guo[SUP] #[/SUP][SUP] 2 [/SUP], Qixian Zheng[SUP] #[/SUP][SUP] 1 [/SUP], Qianyuan Zhang[SUP] 3 [/SUP], Jinghan Chen[SUP] 2 [/SUP], Yuanyuan Cai[SUP] 3 [/SUP], Qiong Luo[SUP] 2 [/SUP], Qian Xu[SUP] 2 [/SUP], Xiangqi Chen[SUP] 4 5 [/SUP], Sheng Yang[SUP] 6 7 [/SUP], Suyun Zhang[SUP] 8 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease 2019 (COVID-19) is frequntly accompanied by venous thromboembolism (VTE), and its mechanism may be related to the abnormal inflammation and immune status of COVID-19 patients. It has been proved that interleukin-6 (IL-6), ferritin and lactate dehydrogenase (LDH) may play an important role in the occurrence of VTE in COVID-19 infection. But whether they can server as predictors for VTE in COVID-19 is still unclear. In this study, we performed a systematic review and meta-analysis to compare IL-6, ferritin and LDH in VTE and non-VTE COVID-19 patients in order to shed light on the prevention and treatment of VTE.
Methods: Related literatures were searched in PubMed, Embase, Web of Science, Google Scholar, China National Knowledge Infrastructure (CNKI), WANGFANG. COVID-19 patients were divided into VTE group and non-VTE group. Meta-analysis was then conducted to compare levels of IL-6, ferritin and LDH between the two groups.
Results: We finally included and analyzed 17 literatures from January 2019 to October 2022. There was a total of 7,035 COVID-19 patients, with a weighted mean age of 60.01 years. Males accounted for 62.64% and 61.34% patients were in intensive care unit (ICU). Weighted mean difference (WMD) of IL-6, ferritin and LDH was 31.15 (95% CI: 9.82, 52.49), 257.02 (95% CI: 51.70, 462.33) and 41.79 (95% CI: -19.38, 102.96), respectively. The above results indicated that than compared with non-VTE group, VTE group had significantly higher levels of IL-6 and ferritin but similar LDH.
Conclusion: This systematic review and meta-analysis pointed out that elevated levels of IL-6 and ferritin were significantly possitive associated with VTE, thus could be used as biological predictive indicators of VTE among COVID-19 patients. However, no association was found between level of LDH and VTE. Therefore, close monitoring of changes in IL-6 and ferritin concentrations is of great value in assisting clinicans to rapidly identify thrombotic complications among COVID-19 patients, hence facilitating the timely effective managment. Further studies are required in terms of the clinical role of cytokines in the occurrence of VTE among COVID-19 infection, with more reliable systematic controls and interventional trials.

Keywords: COVID-19; Cytokine storm; Ferritin; IL-6; LDH; Thrombosis prevention and anticoagulation therapy; VTE.

 
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