AUTHOR=Roy-Vallejo Emilia , Cardeñoso Laura , Triguero-Martínez Ana , Chicot Llano Marta , Zurita Nelly , Ávalos Elena , Barrios Ana , Hernando Julia , Ortiz Javier , Rodríguez-García Sebastián C. , Ciudad Sañudo Marianela , Marcos Celeste , García Castillo Elena , Fontán García-Rodrigo Leticia , González Begoña , Méndez Rosa , Iturrate Isabel , Sanz-García Ancor , Villa Almudena , Sánchez-Azofra Ana , Quicios Begoña , Arribas David , Álvarez Rodríguez Jesús , Patiño Pablo , Trigueros Marina , Uriarte Miren , Martín-Ramírez Alexandra , Arévalo Román Cristina , Galván-Román José María , García-Vicuña Rosario , Ancochea Julio , Muñoz-Calleja Cecilia , Fernández-Ruiz Elena , de la Cámara Rafael , Suárez Fernández Carmen , González-Álvaro Isidoro , Rodríguez-Serrano Diego A. , the PREDINMUN-COVID Group , Sanz Jesús , Casado Pedro , Gutiérrez Ángela , Bautista Azucena , Hernández Pilar , Giménez Nuria Ruiz , Moyano Berta , Gil Paloma , Delgado María Jesús , Parra Pedro , Sánchez Beatriz , Sáez Carmen , Rico Marta Fernández , García Diego Domingo , Cavero Teresa Alarcón , Semiglia Chong María Auxiliadora , Cobos Ainhoa Gutiérrez , Castañeda Santos , Llorente Irene , Tomero Eva G. , Castañeda Noelia García , Montes Nuria , Peña Cristina Dominguez , Jiménez David Jiménez , Villamayor Pablo , Canabal Alfonso , Alonso Tamara , Cisneros Carolina , Valenzuela Claudia , Pérez Francisco Javier García , Girón Rosa María , Aspa Javier , Marcos Celeste , Churruca M. del Perpetuo Socorro , Zamora Enrique , Martínez Adrián , Mayo Mar Barrio , Espi Rosalina Henares , Sánchez-Madrid Francisco , Gayo Enrique Martín , Sánchez-Cerrillo Ildefonso , Jimenez Ana Marcos , Martínez-Fleta Pedro , López-Sanz Celia , Gabrie Ligia , Guerola Luciana del Campo , Tejedor Reyes , Rodríguez Rosa Carracedo TITLE=SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort JOURNAL=Frontiers in Medicine VOLUME=9 YEAR=2022 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.855639 DOI=10.3389/fmed.2022.855639 ISSN=2296-858X ABSTRACT=Background

Interleukin 6 (IL6) levels and SARS-CoV-2 viremia have been correlated with COVID-19 severity. The association over time between them has not been assessed in a prospective cohort. Our aim was to evaluate the relationship between SARS-CoV-2 viremia and time evolution of IL6 levels in a COVID-19 prospective cohort.

Methods

Secondary analysis from a prospective cohort including COVID-19 hospitalized patients from Hospital Universitario La Princesa between November 2020 and January 2021. Serial plasma samples were collected from admission until discharge. Viral load was quantified by Real-Time Polymerase Chain Reaction and IL6 levels with an enzyme immunoassay. To represent the evolution over time of both variables we used the graphic command twoway of Stata.

Results

A total of 57 patients were recruited, with median age of 63 years (IQR [53–81]), 61.4% male and 68.4% Caucasian. The peak of viremia appeared shortly after symptom onset in patients with persistent viremia (more than 1 sample with > 1.3 log10 copies/ml) and also in those with at least one IL6 > 30 pg/ml, followed by a progressive increase in IL6 around 10 days later. Persistent viremia in the first week of hospitalization was associated with higher levels of IL6. Both IL6 and SARS-CoV-2 viral load were higher in males, with a quicker increase with age.

Conclusion

In those patients with worse outcomes, an early peak of SARS-CoV-2 viral load precedes an increase in IL6 levels. Monitoring SARS-CoV-2 viral load during the first week after symptom onset may be helpful to predict disease severity in COVID-19 patients.