517 - Association of the predictive risk scores of CALL points and COVID-GRAM with IL-6, duration of oxygen therapy, D-dimer among patients with COVID-19

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Presenting Author(s)

HY

Hanako Yoshihara

MD
Saitama Medical Center, Jichi Medical University
Saitama, Saitama, Japan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

IK

Ibuki Kurihara

MD
Saitama Medical Center, Jichi Medical University
Saitama, Saitama, Japan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TF

Takahiko Fukuchi

Assistant Professor
Jichi Medical University, Saitama Medical Center
Saitama-shi, Saitama, Japan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
HS

Hitoshi Sugawara

MD
Saitama Medical Center, Jichi Medical University
Saitama, Saitama, Japan
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: The coronavirus disease 2019 (COVID-19) outbreak has caused a global pandemic. Critically ill patients with COVID-19 can develop acute respiratory distress syndrome (ARDS) and thrombosis. Angiotensin-converting enzyme 2 is a functional receptor for severe acute respiratory syndrome coronavirus 2 to gain entry in cells. This receptor is widely expressed in some hematopoietic cells, including monocytes and macrophages. Infection of these cells results in secretion of interleukin (IL)-6 and other inflammatory cytokines. IL-6 and other inflammatory cytokines can cause ARDS and thrombosis. Elevated IL-6 levels are expected to cause more severe cytokine release syndrome. In this study we investigated the association of the predictive risk scores with the IL-6 level, duration of oxygen therapy (DOT), and D-dimer level.

Methods: We enrolled 20 consecutive patients diagnosed with COVID-19 from April 3, 2020, to April 30, 2020, and determined the predictive risk scores of CALL points (Dong J et al. CID 2020) and COVID-GRAM (Liang W et al. JAMA Int. Med2020) on admission. We statically analyzed the regressions between these two scores and the values of IL-6 and D-dimer and DOT.

Results: The regression lines between CALL points and the values of IL-6, D-dimer, DOT were Y=-2.09+0.618X (r=0.821), Y=-0.783+0.213X (r=0.510), and Y=-5.32+1.26X (r=0.744), respectively. The regression lines between COVID-GRAM and the values of IL-6, D-dimer, and DOT were Y=-0.820+0.0344X (r=0.935), Y=-2.70+0.0205X (r=0.774), and Y=-1.92+0.0491X (r=0.765), respectively. These correlation coefficients were statistically significant. The correlation coefficients of CALL points were in the descending order of IL-6, DOT, and D-dimer. The correlation coefficients of COVID-GRAM were in the descending order of IL-6, D-dimer, and DOT. The coefficient between COVID-GRAM and IL-6 was the highest.

Conclusion: These predictive risk scores of CALL points and COVID-GRAM can be surrogate markers for the IL-6 level in patients with COVID-19. Further research is required to understand the prediction of severity in patients with COVID-19.