Krebs von den Lungen 6 (KL-6) levels in COVID-19 ICU patients are associated with mortality

  1. Giuliana Scarpati
  2. Daniela Baldassarre
  3. Massimo Boffardi
  4. Vincenzo Calabrese
  5. Edoardo De Robertis
  6. Graziella Lacava
  7. Filomena Oliva
  8. Pasquale Pagliano
  9. Gabriele Pascale
  10. Giovanni L. Tripepi
  11. Ornella Piazza

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Abstract

Background

Krebs von den Lungen 6 (KL-6) is a high-molecular-weight mucin-like glycoprotein, which is also known as MUC1. KL-6 is mainly produced by type 2 pneumocytes and bronchial epithelial cells, and, therefore, elevated circulating KL-6 levels may denote disorders of the alveolar epithelial lining.

The objective of this study is to verify if KL-6 serum level might support ICU physicians in predicting mortality, risk stratifying and triaging severe COVID-19 patients.

Methods

A retrospective cohort study, including all the COVID-19 patients who measured KL-6 serum values at least once during their ICU stay, was performed. The study sample, 122 patients, was divided in two groups, according to the median KL-6 value at ICU admission (median log-transformed KL-6 value: 6.73 U/ml; group A: KL-6 lower than the median and group B: KL-6 higher than the median).

Results

One-hundred twenty-two ICU patients were included in this study. Mortality was higher in group B than in group A (80 versus 46%; p  < 0.001); both linear and logistic multivariate analyses showed ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (P/F) significantly and inversely related to KL-6 values.

Conclusion

At ICU admission, KL-6 serum level was significantly higher in the most hypoxic COVID-19 patients and independently associated with ICU mortality.

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  1. Version published to 10.1186/s44158-022-00064-5
  2. ScreenIT

    SciScore for 10.1101/2021.11.17.21266464: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Campania SUD Institutional Review Board approved this study (protocol ID 0008402010) as minimal risk research.
    Sex as a biological variable110 subjects were males (73%), 91 were non-survivors, representing a 61% hospital mortality rate.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  3. Version published to 10.1101/2021.11.17.21266464v1 on medRxiv