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PLoS One . Increased KL-6 levels in moderate to severe COVID-19 infection

tetano

Editor, Senior Moderator
PLoS One


. 2022 Nov 28;17(11):e0273107.
doi: 10.1371/journal.pone.0273107. eCollection 2022.
Increased KL-6 levels in moderate to severe COVID-19 infection


Maureen Cambier[SUP] 1 2 [/SUP], Monique Henket[SUP] 1 [/SUP], Anne Noelle Frix[SUP] 1 [/SUP], Stéphanie Gofflot[SUP] 3 [/SUP], Marie Thys[SUP] 4 [/SUP], Sara Tomasetti[SUP] 5 [/SUP], Anna Peired[SUP] 6 [/SUP], Ingrid Struman[SUP] 2 [/SUP], Anne-Françoise Rousseau[SUP] 7 [/SUP], Benoît Misset[SUP] 7 [/SUP], Gilles Darcis[SUP] 8 [/SUP], Michel Moutschen[SUP] 8 9 [/SUP], Renaud Louis[SUP] 1 10 [/SUP], Makon-Sébastien Njock[SUP] 1 10 [/SUP], Etienne Cavalier[SUP] 11 [/SUP], Julien Guiot[SUP] 1 10 [/SUP]



Affiliations

Abstract

Background: The global coronavirus disease 2019 (COVID-19) has presented significant challenges and created concerns worldwide. Besides, patients who have experienced a SARS-CoV-2 infection could present post-viral complications that can ultimately lead to pulmonary fibrosis. Serum levels of Krebs von den Lungen 6 (KL-6), high molecular weight human MUC1 mucin, are increased in the most patients with various interstitial lung damage. Since its production is raised during epithelial damages, KL-6 could be a helpful non-invasive marker to monitor COVID-19 infection and predict post-infection sequelae.
Methods: We retrospectively evaluated KL-6 levels of 222 COVID-19 infected patients and 70 healthy control. Serum KL-6, fibrinogen, lactate dehydrogenase (LDH), platelet-lymphocytes ratio (PLR) levels and other biological parameters were analyzed. This retrospective study also characterized the relationships between serum KL-6 levels and pulmonary function variables.
Results: Our results showed that serum KL-6 levels in COVID-19 patients were increased compared to healthy subjects (470 U/ml vs 254 U/ml, P <0.00001). ROC curve analysis enabled us to identify that KL-6 > 453.5 U/ml was associated with COVID-19 (AUC = 0.8415, P < 0.0001). KL-6 level was positively correlated with other indicators of disease severity such as fibrinogen level (r = 0.1475, P = 0.0287), LDH level (r = 0,31, P = 0,004) and PLR level (r = 0.23, P = 0.0005). However, KL-6 levels were not correlated with pulmonary function tests (r = 0.04, P = 0.69).
Conclusions: KL-6 expression was correlated with several disease severity indicators. However, the association between mortality and long-term follow-up outcomes needs further investigation. More extensive trials are required to prove that KL-6 could be a marker of disease severity in COVID-19 infection.
 
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