Association of Serum Krebs von den Lungen-6 (KL-6) Levels and Disease Severity in Patients Hospitalized with COVID-19

Infect Dis Clin Microbiol. 2023 Dec 29;5(4):292-299. doi: 10.36519/idcm.2023.260. eCollection 2023 Dec.

Abstract

Objective: We aimed to evaluate Krebs von den Lungen-6 (KL-6) as a possible biomarker in determining disease severity in patients with moderate and severe COVID-19.

Materials and methods: This cross-sectional study included moderate or severe COVID-19 patients; critically ill patients who were followed up in the intensive care unit were not included. KL-6 level and routine laboratory test measurements were performed on the first day of admission. The patients were also categorized according to their hyperinflammatory state.

Results: The study included 92 patients, 56 (61%) women. The National Institutes of Health (NIH) score was 2 in 52.2% of the patients and 3 in 47.8%. KL-6 levels did not significantly differ in disease severity (NIH score 2 vs. 3; p=0.15). Median KL-6 values were 52.7 (29.1) in patients with <2 COVID-19 hyperinflammatory syndrome score (cHIS) and 61.7 (32.2) in patients with cHIS ≥ 2 (p= 0.077). KL-6 values tended to be higher among the patients with lower lymphocyte counts, but the difference was not statistically significant (<1000 mm³/L p=0.006 and higher cHIS scores ≥2 p=0.07). KL-6 values were also higher in the patients with diabetes mellitus compared to the remaining patients (p =0.036).

Conclusion: There was no significant association between the serum KL-6 measured at admission and the severity of COVID-19.

Keywords: COVID-19; KL-6; SARS-COV2; biomarker; disease severity.