Exploring the Role of Krebs von den Lungen-6 in Severe to Critical COVID-19 Patients

Abstract

COVID-19 encompasses a broad spectrum of clinical conditions caused by SARS-CoV-2 infection. More severe cases experience acute respiratory and/or multiorgan failure. KL-6 is a glycoprotein expressed mainly from type II alveolar cells with pro-fibrotic properties. Serum KL-6 concentrations have been found in patients with COVID-19. However, the relevance of KL-6 in patients with severe and critical COVID-19 has not been fully elucidated. Methods: Retrospective data from consecutive severe to critical COVID-19 patients were collected at UOC Clinica Pnuemologica “Vanvitelli”, A.O. dei Colli, Naples, Italy. The study included patients with a positive rhinopharyngeal swab for SARS-CoV-2 RNA with severe or critical COVID-19. Results: Among 87 patients, 24 had poor outcomes. The median KL-6 value in survivors was significantly lower when compared with dead or intubated patients (530 U/mL versus 1069 U/mL p < 0.001). KL-6 was correlated with body mass index (BMI) (r: 0.279, p: 0.009), lung ultrasound score (LUS) (r: 0.429, p < 0.001), Chung Score (r: 0.390, p < 0.001). KL-6 was associated with the risk of death or oro-tracheal intubation (IOT) after adjusting for gender, BMI, Charlson Index, Chung Score, and PaO2/FIO2 (OR 1.003 95% CI 1.001–1.004, p < 0.001). Serum KL-6 value of 968 has a sensitivity of 79.2%, specificity of 87.1%, PPV 70.4%, NPV 91.5%, AUC: O.85 for risk of death or IOT. Conclusions: The presented research highlights the relevance of serum KL-6 in severe to critical COVID-19 patients in predicting the risk of death or IOT.

Adiponectin, Leptin, and Resistin Are Dysregulated in Patients Infected by SARS-CoV-2

“…The symptoms of SARS-CoV-2 infection are highly heterogeneous including asymptomatic infection, mild symptoms such as fever, dry cough, and dyspnea, and in more serious cases, multilobar pneumonia and acute respiratory distress syndrome (ARDS) [ 1 ]. The heterogeneity of these clinical manifestations is strongly linked to general health conditions, vaccination state, age, and concomitant morbidities (particularly hypertension, obesity, and/or type 2 diabetes) of COVID-19 patients [ 2 , 3 , 4 , 5 ]. Obesity, through the dysregulation of the adipose tissue’s (AT) endocrine functions, may compromise the immune surveillance system, thus representing a critical risk factor for various infections, complications, and mortality [ 6 , 7 ].…”

COVID-19 Prevention and Treatment

“…Two of the papers of the Special Issue focus on potential mechanism of action involved in COVID-19’s pathogenicity [ 24 , 25 ]: one paper explored the role of krebs von del Lungen-6 in severe-to-critical COVID-19 patients (KL-6 is a glycoprotein expressed mainly from type II alveolar cells with pro-fibrotic properties: serum KL-6 concentrations have been found in patients with COVID-19); and the second one showed potential therapeutic implications of how COVID-19 hijacks the cytoskeleton (after attaching to membrane receptors and entering cells, the SARS-CoV-2 virus co-opts the dynamic intra-cellular cytoskeletal network of microtubules, actin, and the microtubule-organizing center, enabling three factors that lead to clinical pathology: viral load due to intra-cellular trafficking, cell-to-cell spread by filopodia, and immune dysfunction).…”

Strategies Tackling Viral Replication and Inflammatory Pathways as Early Pharmacological Treatment for SARS-CoV-2 Infection: Any Potential Role for Ketoprofen Lysine Salt?

“…Novel drugs targeting host immune factors named host-oriented therapies are currently under development. Virus-host cell interaction prompts the innate immune system response which may be ineffective in determining a complete viral clearance [39,40]. Therefore, the possibility to restore the altered immune responses with these host-oriented therapies offers a great opportunity against viral infections [41][42][43].…”