Editorial comments to “Increased interleukin-6 levels are associated with atrioventricular conduction delay in severe COVID-19 patients”

Many cardiovascular diseases including atherosclerotic ischemic heart diseases, chronic heart failure, and cerebrovascular disorders are associated with chronic and acute inflammatory activation.^{1, 2} In mechanisms of developing arrhythmias, inflammation has recently been reported as one of the important pathogenic factors. In this important and a novel finding has also been recognized as the mechanism of rhythm disturbance complicated with COVID-19 infection.³ Especially, Interleukin-6 has been focused because of possible influence to gap junction of connexin 40 or 43 which is important for the maintenance of normal heart rhythms.^{4, 5} In current issue of this journal, Accioli et al.¹ reported the important role of Interleukin-6 of COVID-19 infection. The study is for the first time conducting prospective study on the role of Interleukin-6 for developing atrioventricular conduction disturbance, even if the numbers of study population was small of 33 patients. Since development of heart rhythm disturbance in patients of COVID-19 is sign for untoward outcome of COVID-19, clarifying the mechanism of atrioventricular conduction disturbance and founding Interleukin-6 possibly become treatment target is very important for treatment of long COVID-19 and severe COVID-19 patients. In this aspect, Accioli et al.'s findings should be confirmed in larger cohort.

Besides, COVID-19 infection, Interleukin-6 levels could be related with pathogenesis of HFpEF patients² or other cardiovascular disorders so that Accioli et al. study could be incentive for further advance in the research of the role of Interleukin-6 in the field of arrhythmia disease other than atrioventricular conduction disturbance.

Authors declare no conflict of interests for this article.