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.
【저자키워드】 Coronavirus disease 2019, Prognosis, severity, Krebs von den Lungen-6, 【초록키워드】 COVID-19, coronavirus disease, Respiratory distress syndrome, Coronavirus disease 2019, ARDS, coronavirus, Hospitalized, Mortality, acute respiratory distress syndrome, Prognosis, severity, disease severity, oxygen, outcome, cardiovascular, serum, sensitivity, specificity, Patient, Japanese, respiratory, disease, Admission, acute respiratory distress, severe disease, on admission, Predictive, respiratory distress, an area, medical records, medical record, partial pressure, arterial partial pressure of oxygen, Respiratory Center, nonsurvivors, syndrome, center, fraction, negative correlation, U/mL, cutoff value, survivor, enrolled, analyzed, significantly, reported, the disease, determine, nonsurvivor, patients with COVID-19, progressed, 【제목키워드】 Coronavirus disease 2019, Mortality, severity, Patient,