Involvement of interleukin 6 in SARS-CoV-2 infection: siltuximab as a therapeutic option against COVID-19

Abstract

In December 2019, a cluster of patients with pneumonia of unknown cause was reported in Wuhan (China). After analysis of respiratory samples, scientists isolated a new virus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the outbreak of coronavirus disease 2019 (COVID-19). The virus spread rapidly with an increasing number of infected patients in multiple countries, and the World Health Organization (WHO) declared the disease pandemic. Since the start of the pandemic to the date of this report, more than 2 285 000 cases have been detected in 213 territories around the world and more than 155 000 people have died. COVID-19 is a zoonotic disease and person-to-person transmission occurs primarily via direct contact or through droplets spread by coughing or sneezing from an infected individual. The main signs and symptoms include fever (87.9%), dry cough (67.7%), fatigue (38.1%), sputum production (33.4%) and shortness of breath (18.6%). Approximately 13.8% of patients have severe disease (dyspnoea, respiratory frequency ≥30/min, blood oxygen saturation ≤93% and PaO2/FiO2 ratio 50% of the lung field within 24–48 hours) and 6.1% are critical (respiratory failure, septic shock and multiple organ dysfunction). Our hypothesis is the possibility of using the drug siltuximab in the management of patients with severe COVID-19 infection. Hence the main objective of our study was to explore the involvement of interleukin (IL) 6, the target of action of siltuximab, in SARS-CoV-2 infection.