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This study was funded with grants: "Fondos Supera COVID19" by Banco Santander and CRUE to CS, RG-V, CM-C, and JA; RD16/0011/0012 and PI18/0371 to IG, from Ministerio de Economia y Competitividad (Instituto de Salud Carlos III) and co-funded by European regional development fund (ERDF) "A way to make Europe"; and co-financed by the Community of Madrid through the COVID-2019 Aid. The work of ER-V has been funded by a Rio-Hortega grant CM19/00149 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III) and co-funded by the European Regional Development Fund (ERDF) "A way to make Europe." SR-G was funded by the Spanish Rheumatology Foundation (grants for physicians-researchers 2018-2021). None of these sponsors have had any role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

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Castillo, Elena GarcíaAuthorSanchez-Azofra, AnaAuthorGalván-Román, José MaríaAuthorAncochea, JulioAuthorMunoz-Calleja, CeciliaAuthorFernandez-Ruiz, ElenaAuthor

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Article

SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort

Publicated to:Frontiers of Medicine. 9 855639- - 2022-06-15 9(), DOI: 10.3389/fmed.2022.855639

Authors: Roy-Vallejo, Emilia; Cardenoso, Laura; Triguero-Martinez, Ana; Chicot Llano, Marta; Zurita, Nelly; Avalos, Elena; Barrios, Ana; Hernando, Julia; Ortiz, Javier; Rodriguez-Garcia, Sebastian C; Ciudad Sanudo, Marianela; Marcos, Celeste; Castillo, Elena Garcia; Garcia-Rodrigo, Leticia Fontan; Gonzalez, Begona; Mendez, Rosa; Iturrate, Isabel; Sanz-Garcia, Ancor; Villa, Almudena; Sanchez-Azofra, Ana; Quicios, Begona; Arribas, David; Rodriguez, Jesus Alvarez; Patino, Pablo; Trigueros, Marina; Uriarte, Miren; Martin-Ramirez, Alexandra; Roman, Cristina Arevalo; Galvan-Roman, Jose Maria; Garcia-Vicuna, Rosario; Ancochea, Julio; Munoz-Calleja, Cecilia; Fernandez-Ruiz, Elena; de la Camara, Rafael; Fernandez, Carmen Suarez; Gonzalez-Alvaro, Isidoro; Rodriguez-Serrano, Diego A

Affiliations

Abstract

BackgroundInterleukin 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. MethodsSecondary 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. ResultsA 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. ConclusionIn 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.

Keywords

covid-19interleukin 6 (il-6)prognosissars-cov-2Covid-19Interleukin 6 (il-6)PrognosisSars-cov-2Viremia

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Frontiers of Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 20/136, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, Research & Experimental.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 1.36, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 2.55 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-08, the following number of citations:

  • WoS: 4
  • Scopus: 6
  • OpenCitations: 4

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-08:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 15.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 15 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.