Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia
Open Access
- 20 February 2021
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 18 (4), 2078
- https://doi.org/10.3390/ijerph18042078
Abstract
KL-6 is a sialoglycoprotein antigen which proved elevated in the serum of patients with different interstitial lung diseases, especially in those with a poorer outcome. Given that interstitial pneumonia is the most common presentation of SARS-CoV2 infection, we evaluated the prognostic role of KL-6 in patients with COVID-19 pneumonia. Patients with COVID-19 pneumonia were prospectively enrolled. Blood samples were collected at the time of enrolment (TOE) and on day 7 (T1). Serum KL-6 concentrations were measured by chemiluminescence enzyme immunoassay using a KL-6 antibody kit (LUMIPULSE G1200, Fujirebio) and the cut-off value was set at >1000 U/mL. Fifteen out of 34 enrolled patients (44.1%) died. Patients with unfavourable outcome showed significantly lower P/F ratio and higher IL-6 values and plasmatic concentrations of KL-6 at TOE compared with those who survived (median KL-6: 1188 U/mL vs. 260 U/mL, p < 0.001). KL-6 > 1000 U/mL resulted independently associated with death (aOR: 11.29, p < 0.05) with a positive predictive value of 83.3%. Our results suggest that KL-6 is a reliable indicator of pulmonary function and unfavourable outcome in patients with COVID-19 pneumonia. A KL-6 value > 1000 U/mL resulted independently associated with death and showed good accuracy in predicting a poorer outcome. KL-6 may thus represent a quick, inexpensive, and sensitive parameter to stratify the risk of severe respiratory failure and death.This publication has 37 references indexed in Scilit:
- A cohort study of mortality predictors and characteristics of patients with combined pulmonary fibrosis and emphysemaBMJ Open, 2012
- KL-6 concentration in pulmonary epithelial lining fluid is a useful prognostic indicator in patients with acute respiratory distress syndromeRespiratory Research, 2011
- Increased levels of KL‐6 and subsequent mortality in patients with interstitial lung diseasesJournal of Internal Medicine, 2006
- Prognostic value of circulating KL‐6 in idiopathic pulmonary fibrosisRespirology, 2006
- Elevation of KL-6, a lung epithelial cell marker, in plasma and epithelial lining fluid in acute respiratory distress syndromeAmerican Journal of Physiology-Lung Cellular and Molecular Physiology, 2004
- KL-6 levels are elevated in plasma from patients with acute respiratory distress syndromeEuropean Respiratory Journal, 2004
- KL-6: A Serum Marker for Interstitial PneumoniaSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1995
- Synergistic effect of retinoids and interferon α on tumor‐induced angiogenesis: Anti‐angiogenic effect on HPV‐harboring tumor‐cell linesInternational Journal of Cancer, 1994
- Difference in sero-diagnostic values among KL-6-associated mucins classified as cluster 9International Journal of Cancer, 1994
- Monitoring of Serum KL-6 Antigen in a Patient with Radiation PneumoniaSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1992