Carpio Carlos, Qasem Ana, Buño Antonio, Borobia Alberto M, Arnalich Francisco, Rey Vega, Lázaro Teresa, Mariscal Pablo, Laorden Daniel, Salgueiro Giorgina, Moreno Alberto, Peiró Concepción, Lorenzo Óscar, Álvarez-Sala Rodolfo
Pneumology Department, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma de Madrid, 28046 Madrid, Spain.
Clinical Analytics Department, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
J Clin Med. 2023 Sep 29;12(19):6299. doi: 10.3390/jcm12196299.
To evaluate KL-6 levels in medium-term post-COVID and to compare them in three groups categorised by the severity of COVID-19, we conducted a real-world, retrospective, cohort study. Data from the COVID-19 episode and follow-up during the post-COVID phase were extracted from the COVID@HULP and POSTCOVID@HULP databases, respectively. For the post-COVID period we included demographics, medical history, symptoms, quality of life, physical activity, anxiety and depression status and laboratory results. Patients were categorised into three groups based on the severity of COVID-19: Group 1 (inpatient critical), Group 2 (inpatient non-critical) and Group 3 (hospitalised at home). KL-6 was measured during the follow-up of the three groups. In all, 802 patients were included (Group 1 = 59; Group 2 = 296; Group 3 = 447 patients). The median age was 59 years (48-70), and 362 (45.2%) were males. At admission, fibrinogen and ferritin levels were lower in Group 3 than in the other groups ( < 0.001). Follow-up data were obtained 124 days (97-149) after the diagnosis of COVID-19. The median levels of fibrinogen, ferritin and KL-6 at follow-up were 336 mg/dL (276-413), 80.5 ng/mL (36-174.3) and 326 U/mL (240.3-440.3), respectively. KL-6 levels were lower in Group 3 than in the other groups (298 U/mL (231.5-398) vs. 381.5 U/mL (304-511.8) (Group 1) and 372 U/mL (249-483) (Group 2) ( < 0.001)). KL-6 was associated with ferritin ( < 0.001), fibrinogen ( < 0.001), D-dimer ( < 0.001) and gamma-glutamyl transferase ( < 0.001). KL-6 levels are less elevated at medium-term post-COVID follow-up in patients with mild COVID-19 than in those with moderate or severe disease. KL-6 is associated with systemic inflammatory, hepatic enzyme and thrombosis biomarkers.
为了评估新冠康复中期的KL-6水平，并比较根据新冠严重程度分类的三组患者的KL-6水平，我们开展了一项真实世界的回顾性队列研究。新冠发作期和新冠康复期随访的数据分别从COVID@HULP和POSTCOVID@HULP数据库中提取。对于新冠康复期，我们纳入了人口统计学、病史、症状、生活质量、身体活动、焦虑和抑郁状态以及实验室检查结果。根据新冠严重程度将患者分为三组：第1组（住院危重症）、第2组（住院非危重症）和第3组（居家治疗）。在三组随访期间测量KL-6水平。总共纳入了802例患者（第1组 = 59例；第2组 = 296例；第3组 = 447例患者）。中位年龄为59岁（48 - 70岁），男性有362例（45.2%）。入院时，第3组的纤维蛋白原和铁蛋白水平低于其他组（P < 0.001）。在新冠确诊后124天（97 - 149天）获得随访数据。随访时纤维蛋白原、铁蛋白和KL-6的中位水平分别为336 mg/dL（276 - 413）、80.5 ng/mL（36 - 174.3）和326 U/mL（240.3 - 440.3）。第3组的KL-6水平低于其他组（298 U/mL（231.5 - 398）vs. 381.5 U/mL（304 - 511.8）（第1组）和372 U/mL（249 - 483）（第2组）（P < 0.001））。KL-6与铁蛋白（P < 0.001）、纤维蛋白原（P < 0.001）、D-二聚体（P < 0.001）和γ-谷氨酰转移酶（P < 0.001）相关。与中度或重度新冠患者相比，轻度新冠患者在新冠康复中期随访时KL-6水平升高幅度较小。KL-6与全身炎症、肝酶和血栓形成生物标志物相关。
