Extension of Lung Damage at Chest Computed Tomography in Severely Ill COVID-19 Patients Treated with Interleukin-6 Receptor Blockers Correlates with Inflammatory Cytokines Production and Prognosis

Lucio Calandriello, Enrico De Lorenzis, Giuseppe Cicchetti, Rosa D’Abronzo, Amato Infante, Federico Castaldo, Annemilia Del Ciello, Alessandra Farchione, Elisa Gremese, Riccardo Marano, Luigi Natale, Maria Antonietta D'Agostino, Silvia Laura Bosello, Anna Rita Larici

Research output: Contribution to journalArticle

Abstract

Elevated inflammatory markers are associated with severe coronavirus disease 2019 (COVID-19), and some patients benefit from Interleukin (IL)-6 pathway inhibitors. Different chest computed tomography (CT) scoring systems have shown a prognostic value in COVID-19, but not specifically in anti-IL-6-treated patients at high risk of respiratory failure. We aimed to explore the relationship between baseline CT findings and inflammatory conditions and to evaluate the prognostic value of chest CT scores and laboratory findings in COVID-19 patients specifically treated with anti-IL-6. Baseline CT lung involvement was assessed in 51 hospitalized COVID-19 patients naive to glucocorticoids and other immunosuppressants using four CT scoring systems. CT data were correlated with systemic inflammation and 30-day prognosis after anti-IL-6 treatment. All the considered CT scores showed a negative correlation with pulmonary function and a positive one with C-reactive protein (CRP), IL-6, IL-8, and Tumor Necrosis Factor & alpha; (TNF-& alpha;) serum levels. All the performed scores were prognostic factors, but the disease extension assessed by the six-lung-zone CT score (S24) was the only independently associated with intensive care unit (ICU) admission (p = 0.04). In conclusion, CT involvement correlates with laboratory inflammation markers and is an independent prognostic factor in COVID-19 patients representing a further tool to implement prognostic stratification in hospitalized patients.
Original languageEnglish
Pages (from-to)981-994
Number of pages14
JournalTomography
Volume9
DOIs
Publication statusPublished - 2023

Keywords

  • COVID-19
  • computed tomography
  • cytokine release syndrome
  • interleukin-6
  • prognosis

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