https://doi.org/10.4081/monaldi.2024.2848
An in-depth investigation of serum Krebs von den Lungen-6 and other biomarkers in COVID-19 severity and mortality
Submitted: November 14, 2023
Accepted: June 3, 2024
Published: July 26, 2024
Accepted: June 3, 2024
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SUPPLEMENTARY MATERIAL: 25
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Krebs von den Lungen-6 (KL-6) is a glycoprotein mainly expressed by type II pneumocytes and recently known as a lung injury biomarker. However, the number of studies is still limited, especially in Indonesian COVID-19 populations. Therefore, we aim to provide correlation, sensitivity, and specificity analyses of KL-6 and other biomarkers in Indonesian COVID-19 severity and mortality. We conducted a cross-sectional study involving adult COVID-19 patients at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia, between March 26, 2021, and August 25, 2021. KL-6 and other biomarker levels were compared according to severity (severe versus non-severe) and mortality (non-survivor versus survivor). We also included the receiver operating characteristic analysis to define the optimal cut-off, sensitivity, and specificity of KL-6 to determine COVID-19 severity and mortality. We enrolled 78 COVID- 19 patients (23 non-survivors), including 39 non-severe and 39 severe patients. There was no significant difference in serum KL-6 levels, neither in severity nor mortality groups. KL-6 had the strongest positive correlations with ferritin in severe patients (r=0.313) and non-survivors (r=0.467). We observed that the best sensitivity was KL-6 combined with platelet-to- lymphocyte ratio (PLR) (0.818) in severe patients and with neutrophil-to-lymphocyte ratio (NLR)/PLR/ferritin/C-reactive protein (0.867) in non-survivors. In contrast, the best specificity was found when KL-6 was combined with NLR/D-dimer (0.750) in severe patients and with D-dimer (0.889) in non-survivors. Serum KL-6 is a useful auxiliary laboratory evaluation index for COVID-19 lung injury to depict its severity and mortality.
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Ethics Approval
This study was approved by the ethics committee of Universitas Airlangga Hospital (ethics number 121/KEP/2021).How to Cite
Witarto, Andro Pramana, Alfian Nur Rosyid, Bendix Samarta Witarto, Shidi Laras Pramudito, and Achmad Januar Er Putra. 2024. “An in-Depth Investigation of Serum Krebs Von Den Lungen-6 and Other Biomarkers in COVID-19 Severity and Mortality”. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2024.2848.
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