tetano
Editor, Senior Moderator
Infect Dis Poverty
. 2023 Apr 24;12(1):43.
doi: 10.1186/s40249-023-01086-z.
Increased interleukin-6 is associated with long COVID-19: a systematic review and meta-analysis
Jing-Xian Yin[SUP] 1 [/SUP], Yannick Luther Agbana[SUP] 2 [/SUP], Zhi-Shan Sun[SUP] 1 [/SUP], Si-Wei Fei[SUP] 1 [/SUP], Han-Qing Zhao[SUP] 1 [/SUP], Xiao-Nong Zhou[SUP] 1 3 [/SUP], Jun-Hu Chen[SUP] 4 [/SUP], Kokouvi Kassegne[SUP] 5 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) can involve persistence, sequelae, and other clinical complications that last weeks to months to evolve into long COVID-19. Exploratory studies have suggested that interleukin-6 (IL-6) is related to COVID-19; however, the correlation between IL-6 and long COVID-19 is unknown. We designed a systematic review and meta-analysis to assess the relationship between IL-6 levels and long COVID-19.
Methods: Databases were systematically searched for articles with data on long COVID-19 and IL-6 levels published before September 2022. A total of 22 published studies were eligible for inclusion following the PRISMA guidelines. Analysis of data was undertaken by using Cochran's Q test and the Higgins I-squared (I[SUP]2[/SUP]) statistic for heterogeneity. Random-effect meta-analyses were conducted to pool the IL-6 levels of long COVID-19 patients and to compare the differences in IL-6 levels among the long COVID-19, healthy, non-postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (non-PASC), and acute COVID-19 populations. The funnel plot and Egger's test were used to assess potential publication bias. Sensitivity analysis was used to test the stability of the results.
Results: An increase in IL-6 levels was observed after SARS-CoV-2 infection. The pooled estimate of IL-6 revealed a mean value of 20.92 pg/ml (95% CI = 9.30-32.54 pg/ml, I[SUP]2[/SUP] = 100%, P < 0.01) for long COVID-19 patients. The forest plot showed high levels of IL-6 for long COVID-19 compared with healthy controls (mean difference = 9.75 pg/ml, 95% CI = 5.75-13.75 pg/ml, I[SUP]2[/SUP] = 100%, P < 0.00001) and PASC category (mean difference = 3.32 pg/ml, 95% CI = 0.22-6.42 pg/ml, I[SUP]2[/SUP] = 88%, P = 0.04). The symmetry of the funnel plots was not obvious, and Egger's test showed that there was no significant small study effect in all groups.
Conclusions: This study showed that increased IL-6 correlates with long COVID-19. Such an informative revelation suggests IL-6 as a basic determinant to predict long COVID-19 or at least inform on the "early stage" of long COVID-19.
Keywords: COVID-19; Immune mediator; Interleukin-6; Long COVID-19; Meta-analysis; SARS-CoV-2.
. 2023 Apr 24;12(1):43.
doi: 10.1186/s40249-023-01086-z.
Increased interleukin-6 is associated with long COVID-19: a systematic review and meta-analysis
Jing-Xian Yin[SUP] 1 [/SUP], Yannick Luther Agbana[SUP] 2 [/SUP], Zhi-Shan Sun[SUP] 1 [/SUP], Si-Wei Fei[SUP] 1 [/SUP], Han-Qing Zhao[SUP] 1 [/SUP], Xiao-Nong Zhou[SUP] 1 3 [/SUP], Jun-Hu Chen[SUP] 4 [/SUP], Kokouvi Kassegne[SUP] 5 [/SUP]
Affiliations
- PMID: 37095536
- DOI: 10.1186/s40249-023-01086-z
Abstract
Background: Coronavirus disease 2019 (COVID-19) can involve persistence, sequelae, and other clinical complications that last weeks to months to evolve into long COVID-19. Exploratory studies have suggested that interleukin-6 (IL-6) is related to COVID-19; however, the correlation between IL-6 and long COVID-19 is unknown. We designed a systematic review and meta-analysis to assess the relationship between IL-6 levels and long COVID-19.
Methods: Databases were systematically searched for articles with data on long COVID-19 and IL-6 levels published before September 2022. A total of 22 published studies were eligible for inclusion following the PRISMA guidelines. Analysis of data was undertaken by using Cochran's Q test and the Higgins I-squared (I[SUP]2[/SUP]) statistic for heterogeneity. Random-effect meta-analyses were conducted to pool the IL-6 levels of long COVID-19 patients and to compare the differences in IL-6 levels among the long COVID-19, healthy, non-postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (non-PASC), and acute COVID-19 populations. The funnel plot and Egger's test were used to assess potential publication bias. Sensitivity analysis was used to test the stability of the results.
Results: An increase in IL-6 levels was observed after SARS-CoV-2 infection. The pooled estimate of IL-6 revealed a mean value of 20.92 pg/ml (95% CI = 9.30-32.54 pg/ml, I[SUP]2[/SUP] = 100%, P < 0.01) for long COVID-19 patients. The forest plot showed high levels of IL-6 for long COVID-19 compared with healthy controls (mean difference = 9.75 pg/ml, 95% CI = 5.75-13.75 pg/ml, I[SUP]2[/SUP] = 100%, P < 0.00001) and PASC category (mean difference = 3.32 pg/ml, 95% CI = 0.22-6.42 pg/ml, I[SUP]2[/SUP] = 88%, P = 0.04). The symmetry of the funnel plots was not obvious, and Egger's test showed that there was no significant small study effect in all groups.
Conclusions: This study showed that increased IL-6 correlates with long COVID-19. Such an informative revelation suggests IL-6 as a basic determinant to predict long COVID-19 or at least inform on the "early stage" of long COVID-19.
Keywords: COVID-19; Immune mediator; Interleukin-6; Long COVID-19; Meta-analysis; SARS-CoV-2.