Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia

Scotto, Riccardo; Pinchera, Biagio; Perna, Francesco; Atripaldi, Lidia; Giaccone, Agnese; Sequino, Davide; Zappulo, Emanuela; Sardanelli, Alessia; Moriello, Nicola Schiano; Stanziola, Anna Agnese; Bocchino, Marialuisa; Gentile, Ivan; Sanduzzi, Alessandro

doi:10.3390/ijerph18042078

Cited by 30 publications

(28 citation statements)

References 35 publications

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“…KL‐6 was measured by 90.3% of mild‐to‐moderate cases, and 96.3% of severe cases, suggesting that the effect of selection bias is very small. Several studies suggest that KL‐6 is a useful biomarker for predicting the severity of COVID‐19 and death 31,32 , which also supports the present results.…”

Section: Discussionsupporting

confidence: 90%

Impact of diabetes and Krebs von den Lungen‐6 on coronavirus disease 2019 severity: A single‐center study from Japan

Yakushiji

Motoyama

Fukuda

et al. 2022

J of Diabetes Invest

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Aims/Introduction Diabetes mellitus is reported as a risk factor for increased coronavirus disease 2019 (COVID‐19) severity and mortality, but there have been few reports from Japan. Associations between diabetes mellitus and COVID‐19 severity and mortality were investigated in a single Japanese hospital. Materials and Methods Patients aged ≥20 years admitted to Osaka City General Hospital for COVID‐19 treatment between April 2020 and March 2021 were included in this retrospective, observational study. Multivariable logistic regression analysis was carried out to examine whether diabetes mellitus contributes to COVID‐19‐related death and severity. Results Of the 262 patients included, 108 (41.2%) required invasive ventilation, and 34 (13.0%) died in hospital. The diabetes group ( n = 92) was significantly older, more obese, had longer hospital stays, more severe illness and higher mortality than the non‐diabetes group ( n = 170). On multivariable logistic regression analysis, age (odds ratio [OR] 1.054, 95% confidence interval [CI] 1.023–1.086), body mass index (OR 1.111, 95% CI 1.028–1.201), history of diabetes mellitus (OR 2.429, 95% CI 1.152–5.123), neutrophil count (OR 1.222, 95% CI 1.077–1.385), C‐reactive protein (OR 1.096, 95% CI 1.030–1.166) and Krebs von den Lungen‐6 (OR 1.002, 95% CI 1.000–1.003) were predictors for COVID‐19 severity ( R 2 = 0.468). Meanwhile, age (OR 1.104, 95% CI 1.037–1.175) and Krebs von den Lungen‐6 (OR 1.003, 95% CI 1.001–1.005) were predictors for COVID‐19‐related death ( R 2 = 0.475). Conclusions Diabetes mellitus was a definite risk factor for COVID‐19 severity in a single Japanese hospital treating moderately‐to‐severely ill patients.

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Section: Discussionsupporting

confidence: 90%

Impact of diabetes and Krebs von den Lungen‐6 on coronavirus disease 2019 severity: A single‐center study from Japan

Yakushiji

Motoyama

Fukuda

et al. 2022

J of Diabetes Invest

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“…The clinical implications of serum KL‐6 and SP‐D levels have been investigated in the above‐stated context. As per reports, both serum KL‐6 and SP‐D levels are elevated in patients with severe COVID‐19 and, therefore, these constituents are useful biomarkers of disease severity 9,11,13,20,21 . In addition to disease severity, serum KL‐6 was reported to predict pulmonary fibrosis followed by infection with SARS‐CoV‐2 10,22 and serum SP‐D was reported to be useful for distinguishing pandemic influenza A (H1N1) from COVID‐19 in patients who required mechanical ventilation 23 .…”

Section: Discussionmentioning

confidence: 79%

Surfactant protein D: A useful biomarker for distinguishing COVID‐19 pneumonia from COVID‐19 pneumonia‐like diseases

Togashi

Kono

Okuma

et al. 2022

Health Science Reports

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Introduction: Computed tomography is useful for the diagnosis of coronavirus disease (COVID-19) pneumonia. However, many types of interstitial lung diseases and even bacterial pneumonia can show abnormal chest shadows that are indistinguishable from those observed in COVID-19 pneumonia. Thus, it is necessary to identify useful biomarkers that can efficiently distinguish COVID-19 pneumonia from COVID-19 pneumonia-like diseases. Herein, we investigated the usefulness of serum Krebs von den Lungen 6 (KL-6) and surfactant protein D (SP-D) for identifying patients with COVID-19 pneumonia among patients with abnormal chest shadows consistent with COVID-19 pneumonia. Method: This was a retrospective cohort study of consecutive patients who underwent evaluation of serum KL-6 and SP-D at a single center from February 2019 to December 2020. A total of 54 patients with COVID-19 pneumonia and 65 patients with COVID-19 pneumonia-like diseases were enrolled in this study from the source population. Serum KL-6 and SP-D levels in both groups were analyzed. Result: The serum levels of KL-6 and SP-D in patients with COVID-19 pneumonia were significantly lower than those in patients with COVID-19 pneumonia-like disease (median [interquartile range]: 208.

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“…The full text of 33 remained studies was assessed for eligibility and 12 case reports or case series ( Horii et al, 2020 ; Inoue et al, 2020 ; Ito et al, 2020 ; Nakamura et al, 2020 ; Scarpati, 2020 , Shibata et al, 2020 ; Shimazu et al, 2020 ; Zeng et al, 2020a ; Fukada et al, 2021 ; Sumimoto et al, 2021 ; Suzuki et al, 2021 ; Yamaya et al, 2021 ), 2 studies that did not report the results clearly ( Miyagami et al, 2021 ; Takeshita et al, 2021 ), 3 studies that did not classify patients based on disease severity ( Frix et al, 2020 ; Chen et al, 2021a ; Scotto et al, 2021 ) and 1 preprint study ( Alimova et al, 2020 ) were excluded. Finally, 15 studies identified as relevant and entered the quality assessment ( Awano et al, 2020 , d'Alessandro et al, 2020a , d'Alessandro and Cameli, 2020 , d'Alessandro et al, 2020b ; Frix et al, 2020 ; jp, 2020 , Saito et al, 2020 ; Wang et al, 2020 ; Xue et al, 2020 ; Anai et al, 2021 ; Bergantini et al, 2021 ; Chen et al, 2021 , d’Alessandro et al, 2021 ; Deng et al, 2021 ; He et al, 2021 ; Peng et al, 2021 ; Scotto et al, 2021 ). Ultimately, 7 studies (1 cross-sectional and 6 case-control studies) met the inclusion criteria of this systematic review ( Awano et al, 2020 , d'Alessandro et al, 2020b ; Saito et al, 2020 ; Bergantini et al, 2021 ; Deng et al, 2021 ; He et al, 2021 ; Peng et al, 2021 ) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Krebs von den Lungen-6 (KL-6) as a clinical marker for severe COVID-19: A systematic review and meta-analyses

Naderi

Rahimzadeh

2022

Virology

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Background Krebs von den Lungen-6 (KL-6) is a molecule that is predominantly expressed by damaged alveolar type II cells, and has been proposed as a marker of COVID-19 and the severity of the disease. Here, we performed a meta-analysis to determine whether KL-6 could be used as a prognostic factor for severe COVID-19. Methods PubMed, Cochrane and Google Scholar were searched until April 20, 2021, and 7 studies were included. KL-6 was considered as the outcome and pooled in meta-analyses. Results All included studies compared KL-6 in severe and non-severe patients. Serum KL-6 was higher in severe COVID-19 patients compared to non-severe (n = 6; SMD = 1.25; 95% CI: 0.99–1.5; P < 0.001) and healthy controls (n = 4; SMD = 3.07; 95% CI: 1.36–4.8; P < 0.001). Conclusion This data collection revealed the potential clinical significance of KL-6 as a non-expensive predictive biomarker in severe COVID-19 and for the categorization of COVID-19 clinical severity.

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Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia

Cited by 30 publications

References 35 publications

Impact of diabetes and Krebs von den Lungen‐6 on coronavirus disease 2019 severity: A single‐center study from Japan

Impact of diabetes and Krebs von den Lungen‐6 on coronavirus disease 2019 severity: A single‐center study from Japan

Surfactant protein D: A useful biomarker for distinguishing COVID‐19 pneumonia from COVID‐19 pneumonia‐like diseases

Krebs von den Lungen-6 (KL-6) as a clinical marker for severe COVID-19: A systematic review and meta-analyses

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