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Recent data suggest that the uncontrolled inflammatory activation observed in these patients, specifically interleukin (IL)\u20106 elevation, may play an important pathogenic role by directly affecting cardiac electrophysiology. The aim of our study was to assess the acute impact of IL\u20106 changes on electrocardiographic indices of atrioventricular conduction in severe COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated (1) the behavior of PR\u2010interval and PR\u2010segment in patients with severe COVID\u201019 during active phase and recovery, and (2) their association with circulating IL\u20106 levels over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During active disease, COVID\u201019 patients showed a significant increase of PR\u2010interval and PR\u2010segment. Such atrioventricular delay was transient as these parameters rapidly normalized during recovery. PR\u2010indices significantly correlated with circulating IL\u20106 levels over time. All these changes and correlations persisted also in the absence of laboratory signs of cardiac strain\/injury or concomitant treatment with PR\u2010prolonging drugs, repurposed or not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study provides evidence that in patients with severe COVID\u201019 and high\u2010grade systemic inflammation, IL\u20106 elevation is associated with a significant delay of atrioventricular conduction, independent of concomitant confounding factors. While transient, such alterations may enhance the risk of severe AVB and associated short\u2010term mortality. Our data provide further support to current anti\u2010inflammatory strategies for severe COVID\u201019, including IL\u20106 antagonists.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.13114","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T11:08:00Z","timestamp":1722424080000},"page":"1137-1148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Increased interleukin\u20106 levels are associated with atrioventricular conduction delay in severe <scp>COVID<\/scp>\u201019 patients"],"prefix":"10.1002","volume":"40","author":[{"given":"Riccardo","family":"Accioli","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Surgery and Neurosciences University of Siena  Siena Italy"},{"name":"Division of Internal Medicine and Geriatrics, Electroimmununology Unit University Hospital of Siena  Siena 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