13 August 2022
: Case report
Interleukin-6 Is a Promising Marker of COVID-19 in Children: A Case Series of 2 Brothers with Severe COVID-19 Pneumonia
Unusual clinical course, Challenging differential diagnosis, Unusual setting of medical care
Maria Cristina Maggio1ABCDEF*, Maria Concetta Failla2ABCDE, Salvatore Giordano2ABCD, Marco Pio La Manna3BC, Guido Sireci3ABCDEFDOI: 10.12659/AJCR.934468
Am J Case Rep 2022; 23:e934468
Abstract
BACKGROUND: To date, Coronavirus disease 2019 (COVID-19) remains a global health concern, with fatalities mostly in older age groups with underlying medical conditions, while children are less likely to manifest severe symptoms.
CASE REPORT: We describe the clinical cases of 2 brothers admitted to our Children’s Hospital for persistent fever and cough during the COVID-19 pandemic. Case 1. A 1.5-year-old boy had fever, expiratory dyspnea, desaturation, oxygen saturation 94-96% with O2, and bilateral hissing and crackling rales. His interleukin-6 level in the acute phase of the disease was 100.41 and at the resolution it was 46.2 pg/ml. Treatment with amoxicillin plus clavulanic acid, methylprednisolone, and O2 allowed progressive improvement of clinical conditions and laboratory data. Case 2. A 3-month-old toddler was admitted to our hospital for fever, cough, and tachypnea, which started 2 days before hospitalization. He had fever, cough, conjunctivitis, mucous rhinorrhea, and 99% oxygen saturation on room air. Thorax auscultation showed whistles and buzzes. He had a positive molecular test result from a COVID-19 swab. Interleukin-6 levels during all the phases of the disease were <6.25 pg/ml. The chest X-ray was normal. Treatment with azithromycin and methylprednisolone was followed by progressive improvement of clinical conditions.
CONCLUSIONS: These cases support the strong correlation between interleukin-6 levels and severe clinical manifestations such as COVID-19 pneumonia, and this marker predicts a more severe clinical outcome in children. Testing serum levels of interleukin-6 in children with COVID-19 could be useful to better understand the outcome of lung damage.
Keywords: bronchopneumonia, COVID-19, cytokine release syndrome, DAB(389)-Interleukin 6, Neutrophil Activation
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