Respir Investig
. 2021 Apr 27;S2212-5345(21)00071-X.
doi: 10.1016/j.resinv.2021.04.002. Online ahead of print.
Serum Krebs von den Lungen-6 levels are associated with mortality and severity in patients with coronavirus disease 2019
Takafumi Yamaya 1 , Eri Hagiwara 1 , Tomohisa Baba 1 , Takaaki Kitayama 1 , Kota Murohashi 1 , Katsuyuki Higa 1 , Yozo Sato 1 , Ryota Otoshi 1 , Erina Tabata 1 , Ryota Shintani 1 , Hiroko Okabayashi 1 , Satoshi Ikeda 1 , Takashi Niwa 1 , Atsuhito Nakazawa 1 , Tsuneyuki Oda 1 , Ryo Okuda 1 , Akimasa Sekine 1 , Hideya Kitamura 1 , Shigeru Komatsu 1 , Takashi Ogura 2
Affiliations
- PMID: 33965361
- DOI: 10.1016/j.resinv.2021.04.002
Abstract
Background: The serum Krebs von den Lungen-6 (KL-6) level is a predictive factor for acute respiratory distress syndrome (ARDS). The development of ARDS has been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to determine whether serum KL-6 levels are associated with mortality and severity in patients with COVID-19.
Methods: Among 361 Japanese patients with COVID-19 who were hospitalized at Kanagawa Cardiovascular and Respiratory Center between February 2020 and December 2020, 356 patients with data on serum KL-6 levels were enrolled and their medical records were retrospectively analyzed.
Results: A negative correlation was observed between KL-6 levels and the ratio of the arterial partial pressure of oxygen to the fraction of inspired oxygen on admission. The KL-6 levels on admission and the maximal KL-6 levels were higher in patients with severe disease (n = 60) than in those with nonsevere disease (n = 296). Furthermore, the maximal KL-6 levels were higher in nonsurvivors (n = 6) than in survivors (n = 350). In nonsurvivors, the KL-6 levels increased as the disease progressed. The optimal cutoff value of the maximal KL-6 level for discriminating between survivors and nonsurvivors was 684 U/mL, with a sensitivity of 83.3%, a specificity of 90.5%, and an area under the curve of 0.89.
Conclusions: The serum KL-6 level was associated with disease severity. Patients with KL-6 levels ?684 U/mL had a significantly poorer outcome than those with KL-6 levels <684 U/mL.
Keywords: Coronavirus disease 2019; Krebs von den Lungen-6; Prognosis; Severity.