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 ( t 1) and 9 ( t 2) months from hospital discharge. At t 0, KL-6 concentrations were significantly higher than those at t 1 (760 (311–1218) vs. 309 (210–408) p = 0.0208) and t 2 (760 (311–1218) vs 324 (279–458), p = 0.0365). At t 0, 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 t 1 (755 (370–1023) vs. 290 (197–521), p = 0.0366) and t 2 (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. Supplementary Information The online version contains supplementary material available at 10.1007/s11739-020-02614-7.
【저자키워드】 COVID-19, Biomarker, Prognosis, KL-6, 【초록키워드】 Hospitalized, mechanical ventilation, lung, Type II pneumocyte, COVID, serum, Clinical course, Accuracy, Patient, Follow-up, Severe patient, university, predict, hospitalized COVID-19 patient, Cytopathic effect, Concentration, Analysis, COVID-19 patient, AUC, lung damage, hospitalized COVID-19 patients, supplementary material, severe patients, assessments, alteration, median age, Siena, hospital discharge, serum concentrations, AUROC, type II pneumocytes, unit, males, radiological, enrolled, selected, identify, develop, evaluate, significantly, reduced, functional, contribute, significantly higher, Area, IQR, Serum concentration, 【제목키워드】 COVID-19 patient,