联合使用血清铁蛋白和 KL-6 水平作为预测 COVID-19 严重程度的生物标志物。

IF 2.4 Q2 RESPIRATORY SYSTEM Respiratory investigation Pub Date : 2024-10-03 DOI:10.1016/j.resinv.2024.09.011

Hiromu Tanaka , Erika Toya , Shotaro Chubachi , Ho Namkoong , Takanori Asakura , Shuhei Azekawa , Shiro Otake , Kensuke Nakagawara , Takahiro Fukushima , Mayuko Watase , Kaori Sakurai , Katsunori Masaki , Hirofumi Kamata , Makoto Ishii , Naoki Hasegawa , Yukinori Okada , Ryuji Koike , Yuko Kitagawa , Akinori Kimura , Seiya Imoto , Koichi Fukunaga

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摘要

目的：评估血清铁蛋白和 Krebs von den Lungen-6 (KL-6)评估血清铁蛋白和Krebs von den Lungen-6 (KL-6)水平预测严重COVID-19（死亡或需要有创机械通气[IMV]/高流量供氧）的价值：利用全国COVID-19数据库中的数据，分析了2020年2月至2022年11月期间2495名COVID-19患者的数据：结果：KL-6水平高、铁蛋白水平低的患者年龄较大，合并症较多，死亡率较高；而铁蛋白水平高、KL-6水平低的患者年龄较轻，男性居多，更有可能需要IMV。两种指标的高水平与危重结果密切相关（调整后的几率比：13.6，95% 置信区间：8.58-21.5）。这两种标记物的组合比单独使用其中一种标记物具有更高的预测价值（曲线下面积：0.709，0.7% 置信区间：0.7%）：结论：KL-6、铁蛋白和 KL-6 + 铁蛋白的曲线下面积分别为 0.709、0.745 和 0.781：结论：两种标记物的组合可准确预测 COVID-19 的严重程度。

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Combined use of serum ferritin and KL-6 levels as biomarkers for predicting COVID-19 severity

Objectives

To assess the value of serum ferritin and Krebs von den Lungen-6 (KL-6) levels for predicting severe COVID-19 (death or requirement for invasive mechanical ventilation [IMV]/high-flow oxygen).

Methods

Data were analyzed on 2495 patients with COVID-19 from February 2020 to November 2022 using data from a nationwide COVID-19 database.

Results

Patients with high KL-6 and low ferritin levels were older with more comorbidities and higher mortality rates, whereas those with high ferritin and low KL-6 levels were younger, predominantly male, and more likely to need IMV. A high level of both markers was strongly associated with critical outcomes (adjusted odds ratio: 13.6, 95% confidence interval: 8.58–21.5). The combination of both markers had higher predictive value than either marker alone (area under the curve: 0.709, 0.745, and 0.781 for KL-6, ferritin, and KL-6 + ferritin, respectively).