Could KL-6 levels in COVID-19 help to predict lung disease?
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LETTER TO THE EDITOR
Open Access
Could KL‑6 levels in COVID‑19 help to predict lung disease? AN Frix1*, L. Schoneveld2, A. Ladang2, M. Henket1, B. Duysinx1, F. Vaillant1, B. Misset3, M. Moutschen4, R. Louis1, E. Cavalier2† and J. Guiot1†
Abstract Background: Coronavirus disease COVID-19 has become a public health emergency of international concern. Together with the quest for an effective treatment, the question of the post-infectious evolution of affected patients in healing process remains uncertain. Krebs von den Lungen 6 (KL-6) is a high molecular weight mucin-like glycoprotein produced by type II pneumocytes and bronchial epithelial cells. Its production is raised during epithelial lesions and cellular regeneration. In COVID-19 infection, KL-6 serum levels could therefore be of interest for diagnosis, prognosis and therapeutic response evaluation. Materials and methods: Our study retrospectively compared KL-6 levels between a cohort of 83 COVID-19 infected patients and two other groups: healthy subjects (n = 70) on one hand, and a heterogenous group of patients suffering from interstitial lung diseases (n = 31; composed of 16 IPF, 4 sarcoidosis, 11 others) on the other hand. Demographical, clinical and laboratory indexes were collected. Our study aims to compare KL-6 levels between a COVID-19 population and healthy subjects or patients suffering from interstitial lung diseases (ILDs). Ultimately, we ought to determine whether KL-6 could be a marker of disease severity and bad prognosis. Results: Our results showed that serum KL-6 levels in COVID-19 patients were increased compared to healthy subjects, but to a lesser extent than in patients suffering from ILD. Increased levels of KL-6 in COVID-19 patients were associated with a more severe lung disease. Discussion and conclusion: Our results suggest that KL-6 could be a good biomarker to assess ILD severity in COVID-19 infection. Concerning the therapeutic response prediction, more studies are necessary. Keywords: COVID-19, Interstitial lung disease, Lung infection, Biomarker, KL-6 Introduction The rapid outbreak of coronavirus disease 2019 (COVID19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, has plainly become a public health emergency of international concern [1, 2]. Despite a wide range of clinical presentation and varying degrees of severity, more than 887.814 people *Correspondence: [email protected] † E. Cavalier and J. Guiot contributed equally. 1 Department of Respiratory Medicine, CHU Liège, University Hospital of Liège, Domaine Universitaire du Sart‑Tilman, B35, 4000 Liège, Belgium Full list of author information is available at the end of the article
worldwide have now recovered from this viral lung infection. Though the number of recoveries does provide solace, there is still little information about how these patients and their lung integrity will evolve throughout the post-infectious healing process. Interstitial lung damage induced by viral infection conventionally leads to respiratory sympto
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