Serum KL-6 Could Represent a Reliable Indicator of Unfavourable Outcome in Patients with COVID-19 Pneumonia

Riccardo Scotto, Biagio Pinchera, Francesco Perna, Lidia Atripaldi, Agnese Giaccone, Davide Sequino, Emanuela Zappulo, Alessia Sardanelli, Nicola Schiano Moriello, Anna Stanziola, Marialuisa Bocchino, Ivan Gentile and Alessandro Sanduzzi
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Riccardo Scotto: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Biagio Pinchera: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Francesco Perna: Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy
Lidia Atripaldi: Laboratory of Clinical Biochemistry, Monaldi Hospital, 80131 Naples, Italy
Agnese Giaccone: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Davide Sequino: Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy
Emanuela Zappulo: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Alessia Sardanelli: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Nicola Schiano Moriello: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Anna Stanziola: Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy
Marialuisa Bocchino: Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy
Ivan Gentile: Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
Alessandro Sanduzzi: Section of Respiratory Diseases, Department of Clinical Medicine and Surgery, Monaldi Hospital, University of Naples Federico II, 80131 Naples, Italy

IJERPH, 2021, vol. 18, issue 4, 1-10

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.

Keywords: COVID-19; SARS-CoV-2; KL-6; pneumonia; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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