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This study was funded with grants: "Fondos Supera COVID19" by Banco Santander and CRUE to CS, RG-V, CM-C, and JA; RD16/0011/0012 and PI18/0371 to IG, from Ministerio de Economia y Competitividad (Instituto de Salud Carlos III) and co-funded by European regional development fund (ERDF) "A way to make Europe"; and co-financed by the Community of Madrid through the COVID-2019 Aid. The work of ER-V has been funded by a Rio-Hortega grant CM19/00149 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III) and co-funded by the European Regional Development Fund (ERDF) "A way to make Europe." SR-G was funded by the Spanish Rheumatology Foundation (grants for physicians-researchers 2018-2021). None of these sponsors have had any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

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SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort

Publicado en:Frontiers of Medicine. 9 855639- - 2022-06-15 9(), DOI: 10.3389/fmed.2022.855639

Autores: Roy-Vallejo, Emilia; Cardenoso, Laura; Triguero-Martinez, Ana; Chicot Llano, Marta; Zurita, Nelly; Avalos, Elena; Barrios, Ana; Hernando, Julia; Ortiz, Javier; Rodriguez-Garcia, Sebastian C; Ciudad Sanudo, Marianela; Marcos, Celeste; Castillo, Elena Garcia; Garcia-Rodrigo, Leticia Fontan; Gonzalez, Begona; Mendez, Rosa; Iturrate, Isabel; Sanz-Garcia, Ancor; Villa, Almudena; Sanchez-Azofra, Ana; Quicios, Begona; Arribas, David; Rodriguez, Jesus Alvarez; Patino, Pablo; Trigueros, Marina; Uriarte, Miren; Martin-Ramirez, Alexandra; Roman, Cristina Arevalo; Galvan-Roman, Jose Maria; Garcia-Vicuna, Rosario; Ancochea, Julio; Munoz-Calleja, Cecilia; Fernandez-Ruiz, Elena; de la Camara, Rafael; Fernandez, Carmen Suarez; Gonzalez-Alvaro, Isidoro; Rodriguez-Serrano, Diego A

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BackgroundInterleukin 6 (IL6) levels and SARS-CoV-2 viremia have been correlated with COVID-19 severity. The association over time between them has not been assessed in a prospective cohort. Our aim was to evaluate the relationship between SARS-CoV-2 viremia and time evolution of IL6 levels in a COVID-19 prospective cohort. MethodsSecondary analysis from a prospective cohort including COVID-19 hospitalized patients from Hospital Universitario La Princesa between November 2020 and January 2021. Serial plasma samples were collected from admission until discharge. Viral load was quantified by Real-Time Polymerase Chain Reaction and IL6 levels with an enzyme immunoassay. To represent the evolution over time of both variables we used the graphic command twoway of Stata. ResultsA total of 57 patients were recruited, with median age of 63 years (IQR [53-81]), 61.4% male and 68.4% Caucasian. The peak of viremia appeared shortly after symptom onset in patients with persistent viremia (more than 1 sample with > 1.3 log10 copies/ml) and also in those with at least one IL6 > 30 pg/ml, followed by a progressive increase in IL6 around 10 days later. Persistent viremia in the first week of hospitalization was associated with higher levels of IL6. Both IL6 and SARS-CoV-2 viral load were higher in males, with a quicker increase with age. ConclusionIn those patients with worse outcomes, an early peak of SARS-CoV-2 viral load precedes an increase in IL6 levels. Monitoring SARS-CoV-2 viral load during the first week after symptom onset may be helpful to predict disease severity in COVID-19 patients.

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