Observational studyEuropean journal of medical research2022
Peak value of serum KL-6 may be useful for predicting poor prognosis of severe COVID-19 patients.
Observational study in European journal of medical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 15 citations in OpenAlex.
- Integrated assessment of total airway count and pneumonia volume on chest computed tomography as a prognostic biomarker for coronavirus disease.European radiology · 2026Article
- Observational
- Novel Biomarkers for SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis.Journal of personalized medicine · 2025Review
- Initial and peak serum levels of Krebs von den Lungen-6 for predicting the prognosis of patients with COVID-19.The Korean journal of internal medicine · 2025Article
- Evaluation of characteristics and prognosis of COVID-19 patients requiring invasive mechanical ventilation during dominance of nonvariant, alpha, delta, and omicron variants in tertiary hospitals of Japan.BMC infectious diseases · 2024Observational
- Clinical experience of treatment of immunocompromised individuals with persistent SARS-CoV-2 infection based on drug resistance mutations determined by genomic analysis: a descriptive study.BMC infectious diseases · 2023Article
- Krebs von den Lungen-6 (KL-6) Levels in Post-COVID Follow-Up: Differences According to the Severity of COVID-19.Journal of clinical medicine · 2023Article
- Serum KL-6 levels predict clinical outcomes and are associated withBMJ open respiratory research · 2023Article
- Usefulness of KL-6 for Predicting Clinical Outcomes in Hospitalized COVID-19 Patients.Medicina (Kaunas, Lithuania) · 2022Article
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Authors and funding
11 authors at 1 institution in 1 country.
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Abstract
backgroundSerum Krebs von den Lungen 6 (KL-6), which reflects alveolar epithelial injury, was reported to be useful to predict the progression of pneumonitis induced by COVID-19 in the early phase. This study aimed to evaluate the peak value of serum KL-6 during hospitalization for COVID-19 to discover a more useful biomarker for predicting prognosis in COVID-19 patients.
methodsIn this retrospective, single-center, observational study, we analyzed the data of 147 hospitalized patients who required supplemental oxygen, high-flow oxygen therapy, or invasive mechanical ventilation for respiratory failure due to COVID-19 from March 2020 to February 2021. We extracted data on patient sex, age, comorbidities, treatment, and biomarkers including the initial and peak values of KL-6. Inclusion criteria were examination of the studied biomarkers at least once within 3 days of admission, then at least once a week, and at a minimum, at least twice during the entire hospitalization. Area under the receiver operating curve (AUC) was analyzed to determine the accuracy of several biomarkers including KL-6 and LDH for predicting poor prognosis defined as survivors requiring invasive mechanical ventilation for over 28 days or non-survivors of COVID-19. Univariable and multivariate logistic regression analyses were performed to investigate the prognostic value of the baseline characteristics and biomarkers.
resultsAmong the 147 patients, 108 (73.5%) had a good prognosis and 39 (26.5%) had a poor prognosis. The AUC analysis indicated that peak KL-6 showed precise accuracy in the discrimination of patients with poor prognosis (AUC 0.89, p < 0.001). The best cut-off value for KL-6 concentration was 966 U/mL (sensitivity 81.6%, specificity84.3%). After adjustment, increasing peak values of KL-6 or LDH were associated with a high risk of poor prognosis, with an adjusted odds ratio of 1.35 for peak value of KL-6, per 100 U/mL increase (95% CI 1.17-1.57, p < 0.001) and 2.16 for peak value of LDH, per 100 U/L increase (95% CI 1.46-3.20, p < 0.001).
conclusionsPeak values of KL-6 and LDH measured during hospitalization might help to identify COVID-19 patients with respiratory failure who are at higher risk for a poor prognosis.
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