Effects of sarilumab on IL-6, IL-10 and IP-10 levels in critically ill COVID-19 patients

Ahmed, Reem M.; Hasanein, Khaled M.; El-Mokhtar, Mohamed A.; Khalaf, Mohammad G.A.; Ghandour, Aliaa M.A.

doi:10.21608/ejmm.2025.360033.1473

Effects of sarilumab on IL-6, IL-10 and IP-10 levels in critically ill COVID-19 patients

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Directorate of Health and Population, Faculty of Pharmacy, Assiut University, Assiut, Egypt.

² Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Egypt

³ Department of Chest Diseases, Assiut University Hospital, Assiut University, Assiut, Egypt

10.21608/ejmm.2025.360033.1473

Abstract

Background: Pandemic COVID-19 caused by SARS-CoV-2. The infection is associated with an inflammatory cytokine storm, which is characterized by elevated levels of pro-inflammatory cytokines as IL-6 and IP-10. Some non-inflammatory cytokines have been investigated in COVID-19 critical cases as IL-10. Early blockade of IL6-pathway might be beneficial in decreasing disease severity. The prospect of employing tocilizumab and sarilumab to treat or prevent the cytokine storm has generated a lot of interest recently. Objective: A trial to evaluate effects of sarilumab on IL-6, IL-10, IP-10 in critically ill COVID-19 patients was done in this study. Methodology: Thirty critically ill COVID-19 patients were enrolled in this study and received sarilumab. Serum baseline, 24hrs and 72hrs after treatment levels of IL-6, IL-10 and IP-10 were evaluated by ELISA kits. Results: Serum levels of IL-6, PaO2 and P/F ratio increased significantly 24hrs after treatment, while levels of IL-10, IP-10 decreased significantly after treatment. There was positive correlation between some markers at baseline level, 24hrs after treatment and 72hrs after treatment, suggesting that these markers are affected by treatment with sarilumab. Accuracy of IL-6, IL-10 and IP-10 measurements 72 hrs after treatment with sarilumab shows significance, indicating that they can help in pathophysiology. Conclusion: COVID-19 infection is significantly associated with high CRP, D-dimer and accompanied with low levels of PaO2 and P/F ratio in critically ill cases. More than half of the ICU patients showed clinical amelioration after sarilumab administration. Dosing and timing of receiving sarilumab play a crucial role in the outcome.

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