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. 2021 Sep;16(6):1541-1545.
doi: 10.1007/s11739-020-02614-7. Epub 2021 Jan 16.

Serial KL-6 measurements in COVID-19 patients

Miriana d'Alessandro  1   2   3 , Laura Bergantini  4   5 , Paolo Cameli, Giuseppe Curatola  4   5 , Lorenzo Remediani  4   5 , David Bennett  4   5 , Francesco Bianchi  4   5 , Felice Perillo  4   5 , Luca Volterrani  4   5 , Maria Antonietta Mazzei  4   5 , Elena Bargagli  4   5 ; Siena COVID
Collaborators, Affiliations

Serial KL-6 measurements in COVID-19 patients

Miriana d'Alessandro et al. Intern Emerg Med. 2021 Sep.

Abstract

SARS-CoV2-induced direct cytopathic effects against type II pneumocytes are suspected to play a role in mediating and perpetuating lung damage. The aim of this study was to evaluate serum KL-6 behavior in COVID-19 patients to investigate its potential role in predicting clinical course. Sixty patients (median age IQR, 65 (52-69), 43 males), hospitalized for COVID-19 at Siena COVID Unit University Hospital, were prospectively enrolled. Twenty-six patients were selected (median age IQR, 63 (55-71), 16 males); all of them underwent follow-up evaluations, including clinical, radiological, functional, and serum KL-6 assessments, after 6 (t1) and 9 (t2) months from hospital discharge. At t0, KL-6 concentrations were significantly higher than those at t1 (760 (311-1218) vs. 309 (210-408) p = 0.0208) and t2 (760 (311-1218) vs 324 (279-458), p = 0.0365). At t0, KL-6 concentrations were increased in patients with fibrotic lung alterations than in non-fibrotic group (755 (370-1023) vs. 305 (225-608), p = 0.0225). Area under the receiver operating curve (AUROC) analysis showed that basal KL-6 levels showed good accuracy in discriminating patients with fibrotic sequelae radiologically documented (AUC 85%, p = 0.0404). KL-6 concentrations in patients with fibrotic involvement were significantly reduced at t1 (755 (370-1023) vs. 290 (197-521), p = 0.0366) and t2 (755 (370-1023) vs. 318 (173-435), p = 0.0490). Serum concentrations of KL-6 in hospitalized COVID-19 patients may contribute to identify severe patients requiring mechanical ventilation and to predict those who will develop pulmonary fibrotic sequelae in the follow-up.

Keywords: Biomarker; COVID-19; KL-6; Prognosis.

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Conflict of interest statement

All the authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
KL-6 concentrations at t0 in serum from COVID19 patients divided according to radiological fibrotic interstitial lung abnormalities after 6 months of hospital discharge
Fig. 2
Fig. 2
Receiver operating curve analysis showed that, basal KL-6 had good accuracy in discriminating patients with HRCT evidence of fibrotic interstitial lung abnormalities
See this image and copyright information in PMC

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