Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19 Lung Injury: A Systematic Review and Meta-Analysis

Witarto, Andro Pramana; Witarto, Bendix Samarta; Putra, Achmad Januar Er; Pramudito, Shidi Laras; Rosyid, Alfian Nur

doi:10.52547/ibj.25.6.381

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…Likewise, a low heterogeneity meta-analysis, performed by Naderi et al showed that KL-6 was significantly higher in patients with severe than non-severe COVID-19 (SMD = 1.25; 95%CI: 0.99 to 1.5; p < 0.001) [ 39 ]. Another meta-analysis conducted by Witarto et al presented similar results: that patients with severe COVID-19 had a higher level of KL-6 than those with the non-severe disease (SMD = 1.16; 95%CI = 0.69 to 1.63) [ 40 ]. In this study, heterogeneity was considered low (I 2 < 25%).…”

Section: Discussionmentioning

confidence: 84%

Prediction Value of KREBS Von Den Lungen-6 (KL-6) Biomarker in COVID-19 Patients: A Systematic Review and Meta-Analysis

Matuszewski

Szarpak

Rafique

et al. 2022

JCM

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The SARS-CoV-2 (COVID-19) pandemic is a major issue that necessitates the use of cutting-edge disease prediction models. The aim of the study was to assess the existing evidence regarding association between Krebs von den Lungen-6 levels and COVID-19 severity. A literature search was performed on Web of Science, PubMed, Scopus and Cochrane Central Register of Controlled Trials databases from 1 January 2020 up to 2 August 2022. The electronic database search was supplemented by searching Google Scholar. In addition, reference lists of relative articles were also reviewed. KL-6 levels among COVID-19 positive vs. negative patients varied and amounted to 443.37 ± 249.33 vs. 205.73 ± 86.8 U/mL (MD = 275.33; 95%CI: 144.57 to 406.09; p < 0.001). The KL-6 level was 402.82 ± 261.16 U/mL in the severe group and was statistically significantly higher than in the non-severe group (297.38 ± 90.46 U/mL; MD = 192.45; 95%CI: 118.19 to 266.72; p < 0.001). The KL-6 level in the mild group was 272.28 ± 95.42 U/mL, compared to 268.04 ± 55.04 U/mL in the moderate COVID-19 group (MD = −12.58; 95%CI: −21.59 to −3.57; p = 0.006). Our meta-analysis indicates a significant association between increased KL-6 levels and SARS-CoV-2 infection. Moreover, KL-6 levels are significantly higher in patients with a more severe course of COVID-19, indicating that KL-6 may be a useful predictor to identify patients at risk for severe COVID-19.

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Section: Discussionmentioning

confidence: 84%

Prediction Value of KREBS Von Den Lungen-6 (KL-6) Biomarker in COVID-19 Patients: A Systematic Review and Meta-Analysis

Matuszewski

Szarpak

Rafique

et al. 2022

JCM

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“…Previous meta-analyses have also shown some association between serum KL-6 and the severity of COVID-19 patients, with the standard mean difference ranging from 1.16 to 1.34. 28 , 29 Such elevated levels have been associated with adverse clinical outcomes including ICU admission, acute respiratory distress syndrome (ARDS), post-COVID-19 fibrosis, and death. 6 If the KL-6 level is recorded in advance, the patient's management plan can be changed by predicting its severity.…”

Section: Discussionmentioning

confidence: 99%

“…25 , 26 Previous meta-analyses have shown that KL-6 has moderate to limited diagnostic value in assessing the severity of COVID-19 infection. 27 , 28 However, another meta-analysis suggested KL-6 as a non-expensive, rapid screening tool for COVID-19 severity. 29 To overcome these hurdles due to an inadequate number of studies, and create more promising evidence, we aimed to conduct an updated meta-analysis between serum KL-6 and the severity of COVID-19 infection.…”

Section: Introductionmentioning

confidence: 99%

Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19: A Systematic Review, Meta-Analysis, and Trial Sequence Analysis

Shrestha

Pokharel

Singh

et al. 2023

Clin Med Insights Circ Respir Pulm Med

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OBJECTIVE This systematic review and meta-analysis aimed to find the association between serum Krebs von den Lungen-6 (KL-6) and the severity of Coronavirus disease 2019 (COVID-19) infection. DATA SOURCES Databases of Embase, PubMed, Web of Science, Science Direct, and Google Scholar were searched for studies reporting KL-6 levels in COVID-19 patients, published between January 2020 and September 30 2022. DATA SYNTHESIS For comparison between the groups, standard mean difference (SMD) and 95% confidence intervals (CI) were computed as the effect sizes. Sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) were measured to assess the diagnostic power of KL-6. In addition, the summary receiver operating characteristics curve (sROC) was constructed to summarize the true positive (TP), and false positive (FP) rates. To validate the findings of meta-analysis, Trial Sequential Analysis (TSA) was conducted. RESULTS Altogether 497 severe COVID-19 patients and 934 non-severe (mild to moderate) COVID-19 patients were included. Pooling of 12 studies indicated that the serum KL-6 level had significant association with severity of COVID-19 infection: standard mean difference = 1.18 (95% CI: 0.93-1.43), p = 0.01; I2: 58.56%]. Pooled diagnostic parameters calculated from eight studies were: sensitivity 0.53 (95% CI: 0.47-0.59); specificity 0.90 (95% CI: 0.88-0.93); positive likelihood ratio 4.80 (95% CI: 3.53-6.53); negative likelihood ratio 0.46 (95% CI: 0.32-0.68); and area under curve: 0.8841. Additionally, TSA verified the adequacy of sample size and robustness of the meta-analysis. CONCLUSION Serum KL-6 level has a moderate degree of correlation with the severity of COVID-19 infection but has low sensitivity. So, it is not recommended as a screening test for severe COVID-19 infection.

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“…Several studies reported that RDW level are significantly associated with stable heart disease and used as an identification of further risks in patient [3,7,8]. Sensitive biomarker is important to diagnosis or prognose the diseases [9][10][11][12][13][14][15][16]. High RDW level can increase the atherosclerosis incidence which is the main cause of CHD [17].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Red Blood Cell Distribution Width (RDW) and Degrees of Severity in Coroner Heart Disease (CHD) Patients Based on Syntax I Score

Muwardi¹,

Gani²,

Diah³

et al. 2022

IJRP

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Coronary heart disease (CHD) is one of the most common causes of death in the world. CHD is caused by the narrowing of the arteries of the heart due to a buildup of fat on the vessel walls (atherosclerosis), therefore inhibiting blood flow to organs. Red blood cell distribution width (RDW) represents the variability of red blood cell size and has been shown to correlate with the incidence of atherosclerosis. RDW is also often used to identify diseases associated with heart failure. The aim of t his study was to assess the relationship between the level of RDW and the severity in CHD patients. A cross-sectional study was carried out on 62 patients from July to December 2020 at Dr. Zainoel Abidin Hospital, Banda Aceh. RDW level was obtained from the patient's medical record and divided into two categories (group 1 < 13.0295 and group 2 >13.029%). Severity of CHD patients was calculated using the SYNTAX I score and divided into three categories (low, moderate, and high). The correlation between the baseline characteristics, laboratory results, RDW level, and severity of CHD was assessed statistically at a 95% confidence l evel. The majority of patients with CHD were men aged 56-65 years and had BMI obesity I and hypertension. Patient baseline characteristics (gender, age, body mass index, history of hypertension and diabetes) and laboratory results did not have a significant relationship with the RDW level and the severity of CHD (p>0.05). The correlation value between RDW level and severity of CHD is p=0.435 which indicated no significant relationship between them.

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Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19 Lung Injury: A Systematic Review and Meta-Analysis

Cited by 9 publications

References 27 publications

Prediction Value of KREBS Von Den Lungen-6 (KL-6) Biomarker in COVID-19 Patients: A Systematic Review and Meta-Analysis

Prediction Value of KREBS Von Den Lungen-6 (KL-6) Biomarker in COVID-19 Patients: A Systematic Review and Meta-Analysis

Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19: A Systematic Review, Meta-Analysis, and Trial Sequence Analysis

Correlation between Red Blood Cell Distribution Width (RDW) and Degrees of Severity in Coroner Heart Disease (CHD) Patients Based on Syntax I Score

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