Assessment of Clinical Symptoms, Serum Interleukin-6 Levels, and HRCT Lung Involvement in COVID-19 Positive Patients Admitted to a Tertiary Care Hospital in South Gujarat: A Secondary Data Analysis

Background: Coronavirus disease 2019 (COVID-19) has a broad clinical spectrum from asymptomatic infection to severe respiratory failure and death. An exaggerated inflammatory response and cytokine release syndrome are key for disease progression. Interleukin-6 (IL-6) has been found to be an essential indicator of inflammation, whereas High-Resolution Computed Tomography (HRCT) is a useful technique to detect pulmonary involvement. The association of IL-6 levels, HRCT results and clinical outcome can help to early risk classification and better management of patients. The objective is to analyze clinical symptoms of patients with COVID-19 and to evaluate correlation of serum IL-6 levels, HRCT lung involvement, illness severity and outcome of patients. Material and Methods: Retrospective secondary data analysis of 300 adult COVID-19-positive admitted patients of New Civil Hospital, Surat. Demographic profile, clinical features, serum IL-6 levels, HRCT findings, severity of the disease and outcomes were reviewed from hospital records. Statistical analysis was done using SPSS version 26. Associations were assessed using chi-square testing and p<0.05 was considered statistically significant. Results: The mean age was 52.5±16.82 years. 67.3% of the sample was male. The most frequent presenting symptoms were cough (99.3%), pyrexia (67.3%) and dyspnea (47.7%). Mild, moderate, severe and critical illness was seen in 40%, 36%, 17% and 7% of patients correspondingly. IL-6 was elevated (>40 pg/mL) in 36% of patients. There was 11% mortality rate. There were significant relationships between clinical severity and IL-6 levels (p<0.001), clinical severity and HRCT lung involvement (p<0.001), IL-6 levels and mortality (p=0.00077), HRCT lung involvement and mortality (p=0.001) and disease severity and mortality (p<0.001). Conclusion: Increased IL-6 levels and HRCT lung involvement were highly linked with severity of disease and mortality in COVID-19 hospitalized patients. Simultaneous assessment of inflammatory and radiological indicators may assist early detection of high risk individuals and better clinical decision making.

Keywords: COVID-19; Interleukin-6; HRCT; Lung involvement; Disease severity; Mortality; Biomarkers.