Abstract

This study aimed to evaluate the association of interleukin-6 (IL-6) level with the poor outcomes in coronavirus disease 2019 (COVID-19) patients by utilizing a meta-analysis based on adjusted effect estimates. We searched the keywords from PubMed, Web of Science, and EMBASE on August 14, 2020. The pooled effects and 95% confidence interval (95% CI) were estimated by Stata 11.2. Subgroup analysis and meta-regression were performed to explore the source of heterogeneity. Sensitivity analysis was implemented to assess the stability of the results. Begg’s test and Egger’s test were conducted to assess the publication bias. Sixteen articles with 8752 COVID-19 patients were finally included in the meta-analysis. The results based on random-effects model indicated that elevated value of IL-6 was significantly associated with adverse outcomes in patients with COVID-19 (pooled effect = 1.21, 95% CI 1.13–1.31, I² = 90.7%). Subgroup analysis stratified by disease outcomes showed consistent results (severe: pooled effect = 1.18, 95% CI 1.05–1.31; ICU (intensive care unit) admission: pooled effect = 1.90, 95% CI 1.04–3.47; death: pooled effect = 3.57, 95% CI 2.10–6.07). Meta-regression indicated that study design was a source of heterogeneity. Publication bias was existent in our analysis (Begg’s test: P = 0.007; Egger’s test: P < 0.001). In conclusion, the elevated IL-6 level is an independent risk factor associated with adverse outcomes in patients with COVID-19.

中文翻译：

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COVID-19 患者的白细胞介素 6 升高和不良结局：基于调整后效应估计的荟萃分析

摘要

本研究旨在通过利用基于调整后效应估计的荟萃分析来评估白细胞介素 6 (IL-6) 水平与 2019 年冠状病毒病 (COVID-19) 患者不良预后之间的关系。我们于 2020 年 8 月 14 日从 PubMed、Web of Science 和 EMBASE 中搜索了关键词。汇总效应和 95% 置信区间 (95% CI) 由 Stata 11.2 估计。进行亚组分析和元回归以探索异质性的来源。进行敏感性分析以评估结果的稳定性。Begg 检验和 Egger 检验用于评估发表偏倚。包含 8752 名 COVID-19 患者的 16 篇文章最终被纳入荟萃分析。I ²  = 90.7%）。按疾病结果分层的亚组分析显示一致的结果（严重：合并效应 = 1.18，95% CI 1.05-1.31；ICU（重症监护病房）入院：合并效应 = 1.90，95% CI 1.04-3.47；死亡：合并效应 = 3.57 , 95% CI 2.10–6.07)。元回归表明研究设计是异质性的来源。我们的分析中存在发表偏倚（Begg 检验：P  = 0.007；Egger 检验：P  < 0.001）。总之，升高的 IL-6 水平是与 COVID-19 患者不良结局相关的独立危险因素。