Evaluation of KL-6 and sRAGE as Alveolar Damage Markers in Pediatric COVID-19 Cases: Is sRAGE the Key Reason for Clinical Differences in Pediatric and Adult COVID-19 Patients?

Authors

Gulsen Akkoc, Marmara University Pendik Training and Research Hospital, Department of Pediatric Infectious Diseases, Pendik, Istanbul, TürkiyeFollow
Berker Okay, Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Department of Pediatrics, Erzincan, Türkiye
Sukran Ozdatli Kurtulus, University of Health Sciences, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Uskudar/Istanbul, Türkiye
Halil Ugur Hatipoglu, University of Health Sciences, Haseki Training and Research Hospital, Department of Pediatrics, Sultangazi, Istanbul, Türkiye
Eda Dilara Bay, University of Health Sciences, Haseki Training and Research Hospital, Department of Pediatrics, Sultangazi, Istanbul, Türkiye
Derya Buyukkayhan, University of Health Sciences, Haseki Training and Research Hospital, Department of Neonatology, Sultangazi, Istanbul, Türkiye

Abstract

Objective: KL-6 and sRAGE, produced by pneumocytes, are novel biomarkers for pulmonary diseases. These markers were found to be elevated in COVID-19 adult patients. The aim of this study was to identify a possible inflammatory biomarker for COVID-19 in children and evaluate these biomarkers to predict clinical course. Methods: Between 01.01.2021 and 31.12.2021, 61 patients (mild and moderate) and 27 control participants aged from 1 month to 18 years were included in the study, and a nonrandomized prospective case-control study was designed. KL-6 and sRAGE levels were evaluated in all participants and compared between each group. Results: The mean age of study group was 14856 months, and 51.1% were girls. There was a statistically significant difference in the median of sRAGE and KL-6 of the groups. sRAGE was statistically significant lower in moderate group than uninfected group, KL-6 was statistically significant higher in moderate group than uninfected and mild groups. In identifying moderate patients, cut-off values of ≥180.3 and ≥3.08 were determined for KL-6 and sRAGE with sensitivity of 71% and 73.3% and specificity of 66.7% and 77.2%, respectively. ROC analysis of KL-6 and sRAGE distinguished COVID-19 patients from healthy subjects, with an area under curve of 0.71 and 0.29, respectively. Conclusion: In conclusion, this study showed that serum KL-6 concentrations were elevated in children with moderate COVID-19, which correlated with the severity of the disease. Furthermore, the low level of sRAGE in moderate patients may help explain the difference between pediatric and adult COVID-19 course.

Recommended Citation

Akkoc, Gulsen; Okay, Berker; Ozdatli Kurtulus, Sukran; Hatipoglu, Halil Ugur; Bay, Eda Dilara; and Buyukkayhan, Derya (2025) "Evaluation of KL-6 and sRAGE as Alveolar Damage Markers in Pediatric COVID-19 Cases: Is sRAGE the Key Reason for Clinical Differences in Pediatric and Adult COVID-19 Patients?," Journal of Pediatric Infectious Diseases: Vol. 20: Iss. 4, Article 2.
Available at: https://jpid.researchcommons.org/journal/vol20/iss4/2