Abstract 17279: Elevated Interleukin-6 Levels in COVID-19-Infected Patients Are Associated With Major Adverse Cardiac Events and/or Mortality

Abstract

Introduction: Interleukin-6 (IL-6) is an inflammatory cytokine marker produced in response to infection and tissue injury. As the COVID-19 pandemic continues to thrive, uncertainties remain regarding COVID-19-related cardiovascular outcomes, specifically major adverse cardiovascular events (MACE). High IL-6 levels correlate with disease severity in COVID-19 patients; however, studies have not shown an association between elevated IL-6 levels and MACE and/or mortality. Methods: Two hundred twenty-five patients tested positive for COVID-19 at a major Southwest quaternary United States hospital between March 2020 and May 2020. Chart review of these patients was used to identify cases of MACE/ mortality and their respective IL-6 levels. This data was extracted for clinical analysis to identify any correlation between IL-6 levels and incidence of MACE and/or death. MACE was defined as a composite of myocardial infarction, stroke, deep venous thrombosis/ pulmonary embolism, or shock requiring vasopressor support. Results: Of the 225 patients with COVID-19, 112 patients had an IL-6 level drawn. Patients with elevated IL-6 levels had a higher incidence of MACE compared to patients with normal IL-6 levels (81.8% vs. 48.5%, p=0.0004, OR=4.77, 95% CI=1.81-13.50). There was a significant difference between the percentage of patients with elevated IL-6 levels who expired and patients with elevated IL-6 levels who did not expire (90.4% vs. 53.9%, p=0.0023, OR=8.11, 95% CI=1.76-74.86). IL-6 levels were significantly higher in patients who developed MACE and expired compared to levels in patients that did not (81.6% vs. 46%, p=0.0001, OR=5.21, 95% CI=2.03-14.13). Conclusions: MACE and/or death in COVID-19 patients were associated with elevated IL-6 levels. It is advisable to obtain IL-6 levels in all COVID-19 infected patients to help risk stratify these patients and treat IL-6 positive patients more aggressively.