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. 2021 Jun:517:48-53.
doi: 10.1016/j.cca.2021.02.012. Epub 2021 Feb 22.

Correlation of Krebs von den Lungen-6 and fibronectin with pulmonary fibrosis in coronavirus disease 2019

Ding-Hui Peng  1 , Yi Luo  1 , Li-Jun Huang  2 , Fan-Lu Liao  1 , Yan-Yuan Liu  1 , Peng Tang  1 , Han-Ning Hu  3 , Wei Chen  4
Affiliations

Correlation of Krebs von den Lungen-6 and fibronectin with pulmonary fibrosis in coronavirus disease 2019

Ding-Hui Peng et al. Clin Chim Acta. 2021 Jun.

Abstract

Objective: Coronavirus Disease 2019 (COVID-19) caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is still spreading worldwide, which may progress to pulmonary fibrosis (PF), leading to the worsen outcome. As the markers of lung injury, the correlation of Krebs von den Lungen-6 (KL-6) and fibronectin (Fn) with pulmonary fibrosis in COVID-19 was still unclear.

Methods: 113 patients diagnosed as COVID-19 were enrolled in this retrospective study, and divided into three categories as mild, moderate and severe cases. The concentrations of serum KL-6 and Fn at hospital admission were tested using the method of latex agglutination assay and immunoturbidimetic assay, respectively.

Results: Compared with that in the non-severe COVID-19 cases and normal control subjects, serum KL-6 concentration on admission was significantly higher in the severe group, which was positively correlated with C-reactive protein, and negatively correlated with lymphocytes count. Whereas, no obvious elevation in serum Fn concentration was investigated in COVID-19 patients with the different phenotypes. The severe cases displayed the higher incident rate of pulmonary fibrosis at hospital discharge. Compared with non-PF patients, the COVID-19 cases with PF had the higher serum KL-6 values.

Conclusion: Serum KL-6 concentration was significantly elevated in severe COVID-19 patients, which may be useful for evaluating the disease severity. For early prevention of the development of pulmonary fibrosis, high concentrations of serum KL-6 in the early stage of COVID-19 should be paid close attention.

Keywords: Coronavirus Disease 2019; Fibronectin; Krebs von den Lungen-6; Pulmonary fibrosis; SARS-CoV-2.

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Conflict of interest statement

The author declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Serum Krebs von den Lungen-6 (KL-6) and fibronectin (Fn)concentrationsin COVID-19 patients. Serum concentrations of KL-6 (A) and Fn (B) in the control subjects (n = 65), suspected cases (n = 36), mild COVID-19 cases (n = 49), moderate COVID-19 cases (n = 28), and severe COVID-19 cases (n = 36). Data are shown as median (interquartile range), *p < 0.05, compared with the other groups.
Fig. 2
Fig. 2
Serum KL-6 positively correlated with CRP concentration and negatively correlated with LC count in severe COVID-19 patients. (A) Correlation between serum Krebs von den Lungen-6 (KL-6) and C-reactive protein (CRP) (n = 36). (B) Correlation between between serum KL-6 and lymphocytes (LC) count in severe COVID-19 cases (n = 36).
Fig. 3
Fig. 3
Receiver operating characteristic (ROC) curve analysis of serum KL-6 in severe COVID-19 patients.
Fig. 4
Fig. 4
Comparison of serum KL-6 and Fn concentrations between COVID-19 patients with and without pulmonary fibrosis (PF). Serum concentrations of KL-6 (A) and Fn (B) in the PF-developed (n = 19) and non-PF COVID-19 (n = 94) patients. Data are shown as median (interquartile range), *p < 0.05, compared with the non-PF COVID-19 group.
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