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Serum Krebs von den Lungen-6 for Predicting the Severity of COVID-19: A Systematic Review, Meta-Analysis, and Trial

Abhigan Babu Shrestha1, Pashupati Pokharel2, Harendra Singh3

  • 1Department of Internal Medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh.

Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
|January 30, 2023
PubMed

Insights

Serum Krebs von den Lungen-6 (KL-6) shows a moderate association with COVID-19 severity. However, its low sensitivity means it is not recommended for screening severe Coronavirus disease 2019 infections.

Area of Science:

  • Biochemistry
  • Pulmonology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is a global health crisis.
  • Identifying biomarkers for COVID-19 severity is crucial for patient management.
  • Krebs von den Lungen-6 (KL-6) is a biomarker associated with lung injury.

Purpose of the Study:

  • To systematically review and meta-analyze the association between serum KL-6 levels and COVID-19 severity.
  • To evaluate the diagnostic performance of KL-6 for severe COVID-19.

Main Methods:

  • Systematic literature search of Embase, PubMed, Web of Science, Science Direct, and Google Scholar (Jan 2020–Sep 2022).
  • Meta-analysis of 12 studies including 497 severe and 934 non-severe COVID-19 patients.
  • Calculation of standard mean difference (SMD), sensitivity, specificity, likelihood ratios, and summary receiver operating characteristic (sROC) curve.
  • Trial Sequential Analysis (TSA) for validation.

Main Results:

  • Serum KL-6 levels were significantly associated with COVID-19 severity (SMD = 1.18, 95% CI: 0.93–1.43, p = 0.01).
  • Pooled diagnostic parameters showed sensitivity of 0.53 (95% CI: 0.47–0.59) and specificity of 0.90 (95% CI: 0.88–0.93).
  • The area under the sROC curve was 0.8841, and TSA confirmed the robustness of the findings.

Conclusions:

  • Serum KL-6 demonstrates a moderate correlation with COVID-19 severity.
  • Despite good specificity, the low sensitivity of KL-6 limits its utility as a screening tool for severe COVID-19.
  • Further research may explore KL-6 in conjunction with other biomarkers for improved diagnostic accuracy.
Abstract

Keywords:
“COVID-19”“Coronavirus disease”“KL-6”“Krebs von den Lungen-6”“Severe COVID-19”“meta-analysis”

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