The Cardiovascular Effects of Interleukin-6 Inhibition in Patients with Severe Coronavirus-19 Infection

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dc.contributor.authorBinder, Michael S.en
dc.contributor.authorTimmerman, Clintonen
dc.contributor.authorMarof, Biwaren
dc.contributor.authorWu, Yingxingen
dc.contributor.authorBankole, Adegbengaen
dc.contributor.authorHeletz, Idoen
dc.date.accessioned2025-04-15T17:52:13Zen
dc.date.available2025-04-15T17:52:13Zen
dc.date.issued2025-04-02en
dc.description.abstractObjective: The coronavirus disease 2019 (COVID-19) pandemic illustrated the relationship between cardiac arrhythmias and pro-inflammatory states. Pro-inflammatory cytokines, including interleukin-6 (IL-6), have significant effects on cardiac conduction. Atrial or ventricular arrhythmias occurring while infected results in a doubling of mortality. Tocilizumab, a monoclonal antibody that blocks the IL-6 receptor, is associated with improved mortality and is believed to be related to immune modulation of the COVID-19–related hyperinflammatory state. Methods: A single-center retrospective review of all patients with severe COVID-19, defined as admission to an intensive care unit or requirement of respiratory or circulatory support, from March 2020 through March 2022, was conducted. Patients who received or did not receive tocilizumab were grouped into the treatment and control groups, respectively. Results: Four hundred seventy-three patients were reviewed and 400 met the criteria for inclusion in our study. There were 305 patients (age, 63 ± 13 years, 58% male) in the control group and 95 (age, 57 ± 15 years, 51% male) in the treatment group. In-hospital mortality was greatly reduced with tocilizumab compared with controls (44.2% vs 85.9%, p < 0.001) and new-onset atrial fibrillation (AF) showed a statistically significant reduction (17.8% vs 29.5%, p = 0.019). New-onset wall motion abnormalities, potentially related to myocarditis or acute coronary syndrome, also trended toward significance with tocilizumab (7.7% vs 15.7%, p = 0.10). Deep vein thrombosis, pulmonary embolism, stroke, and sustained ventricular arrhythmias did not meet statistical significance. Conclusion: As expected, tocilizumab did show significant improvement in mortality. Tocilizumab also showed a significant reduction of new-onset AF. Other cardiac structural endpoints did not reach statistical significance.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1177/03000605251324590en
dc.identifier.eissn1473-2300en
dc.identifier.issn0300-0605en
dc.identifier.issue4en
dc.identifier.orcidHeletz, Ido [0009-0000-1397-0434]en
dc.identifier.otherPMC11967226en
dc.identifier.pmid40173032en
dc.identifier.urihttps://hdl.handle.net/10919/125203en
dc.identifier.volume53en
dc.language.isoenen
dc.publisherSAGE Publishingen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/40173032en
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectatrial fibrillationen
dc.subjectCOVID-19en
dc.subjectIL-6en
dc.subjectTociluzimaben
dc.subjectArrhythmiasen
dc.subjectcoronavirus-19en
dc.subjectinflammationen
dc.subjecttocilizumaben
dc.subject.meshHumansen
dc.subject.meshReceptors, Interleukin-6en
dc.subject.meshInterleukin-6en
dc.subject.meshHospital Mortalityen
dc.subject.meshRetrospective Studiesen
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshMiddle Ageden
dc.subject.meshFemaleen
dc.subject.meshMaleen
dc.subject.meshArrhythmias, Cardiacen
dc.subject.meshAntibodies, Monoclonal, Humanizeden
dc.subject.meshCOVID-19en
dc.subject.meshSARS-CoV-2en
dc.subject.meshCOVID-19 Drug Treatmenten
dc.titleThe Cardiovascular Effects of Interleukin-6 Inhibition in Patients with Severe Coronavirus-19 Infectionen
dc.title.serialJournal of International Medical Researchen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dcterms.dateAccepted2025-01-23en
pubs.organisational-groupVirginia Techen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Internal Medicine/Cardiologyen

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