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Cited by 763COVID-19 Clinical Research StudiesSARS-CoV-2 and COVID-19 ResearchAutoimmune and Inflammatory Disorders Research

Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)?

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Liu, Bingwen, Li, Min, Zhou, Zhiguang, Guan, Xuan, Xiang, Yufei·2020·Journal of Autoimmunity
DOI 10.1016/j.jaut.2020.102452PMC PMC7151347
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Abstract

The emergent outbreak of coronavirus disease 2019 (COVID-19) has caused a global pandemic. Acute respiratory distress syndrome (ARDS) and multiorgan dysfunction are among the leading causes of death in critically ill patients with COVID-19. The elevated inflammatory cytokines suggest that a cytokine storm, also known as cytokine release syndrome (CRS), may play a major role in the pathology of COVID-19. However, the efficacy of corticosteroids, commonly utilized antiinflammatory agents, to treat COVID-19-induced CRS is controversial. There is an urgent need for novel therapies to treat COVID-19-induced CRS. Here, we discuss the pathogenesis of severe acute respiratory syndrome (SARS)-induced CRS, compare the CRS in COVID-19 with that in SARS and Middle East respiratory syndrome (MERS), and summarize the existing therapies for CRS. We propose to utilize interleukin-6 (IL-6) blockade to manage COVID-19-induced CRS and discuss several factors that should be taken into consideration for its clinical application.

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  • Blood IL-6 level is highly correlated with COVID-19 disease mortality.

    “Among the elevated inflammatory mediators, the blood IL-6 level is highly correlated with the disease mortality (293, 338) and predicts the need for mechanical ventilation (339).”

    From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [338]

    The paper states in its main text (indexed under Abstract; page unavailable) that a large retrospective cohort study found IL-6 levels correlated with mortality in patients with COVID-19. It does not establish that the correlation was *high*, so the claim overstates the reported strength. The mechanical-ventilation claim is attached to a different citation and is not assessed here. (LLM, conf=0.85)

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Authors
Liu, B., Li, M., Zhou, Z., Guan, X., & Xiang, Y.
Affiliations
  • Central South University (CN)
  • AdventHealth Orlando (US)
Corresponding author
  • Guan, Xuan
  • Xiang, Yufei
ORCID
Venue
Journal of Autoimmunity
Publisher
Elsevier BV
Published
2020-07
Volume
111
Pages
102452
ISSN
0896-8411 (ISSN-L)
DOI
10.1016/j.jaut.2020.102452
PMC
PMC7151347
OpenAlex
W3016263512
Cited by
763
References
117
Citations by year
2026: 9 · 2025: 20 · 2024: 44 · 2023: 68 · 2022: 139 · 2021: 218 · 2020: 265
FWCI
8.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Autoimmunity (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Foundation for the Study of Diabetes
  • National Natural Science Foundation of China
  • Central South University
Topics
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
Keywords
interleukin-6 blockade, cytokine release syndrome, COVID-19 pandemic, SARS, MERS, cytokine storm, acute respiratory distress syndrome, multiple organ failure, anti-inflammatory therapy, corticosteroids
MeSH terms
Betacoronavirus, Cytokine Release Syndrome, COVID-19, SARS-CoV-2, Interleukin-6 Inhibitors, Anti-Inflammatory Agents, Humans, Pneumonia, Viral, Interleukin-6, Coronavirus Infections, Severe Acute Respiratory Syndrome, Immunomodulation, Pandemics, Antibodies, Monoclonal, Humanized

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