Home Care Follow up determine the point of inversion of IL-6 levels in relation to C-Reactive Protein as the cytokine storm marker in COVID-19

  1. Sérgio Paulo de Mello Mendes Filho
  2. Fernanda Simão Martins
  3. Paulo Jose Giroldi
  4. Raul Honorato e Melo
  5. Edcleia Lopes de Oliveira
  6. Anibal Borin dos Santos
  7. Dayse Cristina Oliveira Medeiros
  8. Sergio de Almeida Basano
  9. Jéssica Amaral Lopes
  10. Yury Oliveira Chaves
  11. Rebeca Sousa Pinheiro
  12. Luís Marcelo Aranha Camargo
  13. Juliana Pavan Zuliani
  14. Paulo Afonso Nogueira

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Abstract

The IL-6 has been used for the characterization of the cytokine storm induced by SARS-CoV-2, but so far, no one has found out when and in whom the cytokine storm develops. Our study demonstrates how early and longitudinal clinical-based monitoring and dosing of five markers (C-reactive protein, IL-6, fibrinogen, ferritin and D-dimer) helped to identify who’d developed the cytokine storm. The peak of IL-6 in pg/mL proportionally higher than the peak of CRP in mg/L was sufficient to define the timing of the evolution of cytokine storm syndrome. The administration of antibiotic therapy, anticoagulant therapy and pulse therapy resolved the infection and prevented the progressive deterioration of the lung function of the patients with potential for development of severe COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2022.03.21.22270828: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado Ethics Review Board (CAAE: 51963021.9.0000.000) and the requirement for informed consent was waived by the Ethics Commission because these data come from medical and laboratory assistance that took place between 2020 and 2021 and medical records were available anonymously encoded.
    Consent: The study was approved by the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado Ethics Review Board (CAAE: 51963021.9.0000.000) and the requirement for informed consent was waived by the Ethics Commission because these data come from medical and laboratory assistance that took place between 2020 and 2021 and medical records were available anonymously encoded.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    GREEN PATIENT: characterized as patients that only presented increased ferritin levels.
    GREEN
    suggested: (GReEn, RRID:SCR_009264)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study also has some significant limitations. The drawbacks of the work were that, for some patients there are not all data of five markers daily, despite our efforts to perform the monitoring and dosing of five markers every day. That is due some patients did not present in the LEPAC or they were not found in their residences.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.03.21.22270828v1 on medRxiv