ABSTRACT
Background: Krebs von den Lungen-6 (KL-6) is a mucin glycoprotein mainly produced on the surface of alveolar type 2 epithelial cells. Some case-control studies comparing healty subjects to COVID-19 patients in different stages of severity have documented that serum KL-6 levels predict COVID-19 severity and poor clinical outcomes. However, the relevance of KL-6 in patients with severe and critical COVID-19 have not fully elucidated. Method(s): Retrospective data from consecutive severe to critical COVID-19 patients were collected at UOC Clinical Pnuemologica "Vanvitelli", A.O. dei Colli, Naples, Italy. Study included patients with a positive rhinopharyngeal swab for SARS-COV-2 RNA with severe or critical COVID-19. Result(s): Study population characteristics are reported in Table 1. Among 87 patients 24 had poor outcomes (IOT or death). Median KL-6 value in survivors was significantly lower when compared with patients dead or intubated (530 U/mL versus 1069 U/mL p<0.001). KL-6 was correlated with BMI (r: 0.279, p:0.009), LUS Score (r: 0.429, p<0.001), Chung Score (r: 0.390, p<0.001). KL-6 was associated with risk of death or IOT after adjusting for gender, BMI, Charlson Index, Chung Score, and P/F (OR 1.003 95%IC 1.001-1.004, p <0.001). Serum KL-6 value of 968 has a sensivity of 79.2%, specificity of 87.1%, PPV 70.4%, NPV 91.5%, AUC: O.85 for risk of death or IOT (Figure 1). Conclusion(s): 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.
ABSTRACT
Background: The COVID-19 pandemic has impacted individuals' eating and lifestyle habits with multiple studies reporting increases in weight. However, the impact of social distancing, stay-at- home policies, and COVID-19 illness on individuals with overweight and obesity who are medically managed for their weight remains unknown. Methods: 4882 adult patients who had been seen at a large urban weight management practice between May 1, 2019 and May 1, 2020 were identified via electronic health record query and invited to anonymously complete an electronic survey between February 23, 2021 and March 23, 2021 that included questions about demographics, weight, eating and lifestyle behaviors, and use of anti-obesity medications. Results: Of the 1006 survey respondents, 77% identified as female, 83.5% as white, 5.1% Hispanic, 4.4% Black, and 2.9% Asian. Median BMI at the beginning of the pandemic was 30.4 kg/m2;13% of participants had normal BMI, 34% had overweight, and 53% had obesity. Anti-obesity pharmacotherapy was common (81%) and 28.9% reported an escalation of their medication regimen during the pandemic. The median weight change for patients taking anti-obesity pharmacotherapy was -1 lbs (-0.454%) compared to +5 lbs (+2.33%) for those not taking it (p < 0.001). Of the total cohort, 21% gained ≥5% body weight, 25% lost ≥5%, and 54% experienced <5% body weight change. Participants reported eating more meals cooked at home and being much less physically active compared to pre-pandemic conditions. Increases in unhealthy food choices, snacking, and comfort eating were reported by 40%, 43% and 49% respectively, as was decreased alcohol consumption (41%). Conclusions: The majority of patients medically managed for their weight at this academic weight management center remained relatively weight stable despite challenges imposed by social distancing/ stay-at- home policies. In contrast to multiple studies illustrating pandemic-related weight gain, this study highlights the protective effect of medical weight management.