Calprotectin and SARS-CoV-2: A Brief-Report of the Current Literature

Giuffrè, Mauro; Vetrugno, Luigi; Bella, Stefano Di; Moretti, Rita; Berretti, D.; Crocè, Lory Saveria

doi:10.3390/healthcare9080956

Cited by 9 publications

(7 citation statements)

References 43 publications

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“…Giuffre et al suggest that fecal calcoprotein (FC) may be a biomarker for the severity of gastrointestinal complications, by both ischemic and inflammatory mechanisms [ 75 ]. They found particularly elevated levels of FC to be well correlated with D-dimers levels in patients with bowel perforations, and hypothesized that the mechanism may be related to a thrombosis localized to the gut and that FC increase is related to virus-related inflammation and thrombosis-induced ischemia, as shown by gross pathology [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Mesenteric Ischemia in COVID-19 Patients

Serban

Tribus

Vancea

et al. 2021

JCM

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Acute mesenteric ischemia is a rare but extremely severe complication of SARS-CoV-2 infection. The present review aims to document the clinical, laboratory, and imaging findings, management, and outcomes of acute intestinal ischemia in COVID-19 patients. A comprehensive search was performed on PubMed and Web of Science with the terms “COVID-19” and “bowel ischemia” OR “intestinal ischemia” OR “mesenteric ischemia” OR “mesenteric thrombosis”. After duplication removal, a total of 36 articles were included, reporting data on a total of 89 patients, 63 being hospitalized at the moment of onset. Elevated D-dimers, leukocytosis, and C reactive protein (CRP) were present in most reported cases, and a contrast-enhanced CT exam confirms the vascular thromboembolism and offers important information about the bowel viability. There are distinct features of bowel ischemia in non-hospitalized vs. hospitalized COVID-19 patients, suggesting different pathological pathways. In ICU patients, the most frequently affected was the large bowel alone (56%) or in association with the small bowel (24%), with microvascular thrombosis. Surgery was necessary in 95.4% of cases. In the non-hospitalized group, the small bowel was involved in 80%, with splanchnic veins or arteries thromboembolism, and a favorable response to conservative anticoagulant therapy was reported in 38.4%. Mortality was 54.4% in the hospitalized group and 21.7% in the non-hospitalized group (p < 0.0001). Age over 60 years (p = 0.043) and the need for surgery (p = 0.019) were associated with the worst outcome. Understanding the mechanisms involved and risk factors may help adjust the thromboprophylaxis and fluid management in COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Acute Mesenteric Ischemia in COVID-19 Patients

Serban

Tribus

Vancea

et al. 2021

JCM

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“…To a lesser extent however, cCLP passively leaks from necrotic cells and is also released in neutrophil extracellular traps (NETs) [25] . NETs are highly efficient in trapping, neutralizing and killing viruses and bacteria [26] , but, when not properly regulated, are also known for its pathogenic role in various thrombo-inflammatory states including respiratory failure [27] . Interestingly, a recent study discovered NETs in postmortem lung specimens of COVID-19 patients, especially in the airway compartment and neutrophil-rich inflammatory areas of the interstitium [10] , [28] .…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of circulating calprotectin levels on the clinical course of COVID-19 differs between serum, heparin, EDTA and citrate sample types

Nevejan

Strypens

Nieuwenhove

et al. 2022

Clinica Chimica Acta

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Introduction During the recent SARS-CoV-2 pandemic, circulating calprotectin (cCLP) gained interest as biomarker to predict the severity of COVID-19. We aimed to investigate the prognostic value of cCLP measured in serum, heparin, EDTA and citrate plasma. Materials and Methods COVID-19 patients were prospectively included, in parallel with two SARS-CoV-2 negative control populations. The prognostic value of cCLP was compared with IL-6, CRP, LDH, procalcitonin, and the 4C-mortality score by AUROC analysis. Results For the 136 COVID-19 patients, cCLP levels were higher compared to the respective control populations, with significantly higher cCLP levels in serum and heparin than in EDTA or citrate. Higher cCLP levels were obtained for COVID-19 patients with i) severe/critical illness (n=70), ii) ICU admission (n=66) and iii) need for mechanical ventilation/ECMO (n=25), but iv) not in patients who deceased within 30 days (n=41). The highest discriminatory power (AUC [95% CI]) for each defined outcome was i) CRP (0.835 [0.755-0.914]); ii) EDTA cCLP (0.780 [0.688-0.873]); iii) EDTA cCLP (0.842 [0.758-0.925]) and iv) the 4C-mortality score (0.713 [0.608-0.818]). Conclusion Measuring cCLP in COVID-19 patients helps the clinician to predict the clinical course of COVID-19. The discriminatory power of EDTA and citrate plasma cCLP levels often outperforms heparin plasma cCLP levels.

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“…Fecal calprotectin is a calcium-binding and primarily neutrophil-specific protein that is released into the extracellular environment as a result of a neutrophil disintegration cascade during acute inflammation. Interestingly, the concentration of fecal calprotectin, which accounts for 60% of the cytosolic protein in neutrophils, is proportional to the concentration of neutrophils in the intestinal mucosa, wherein the functions are severely affected by ischemia [ 26 , 29 , 30 ]. Therefore, fecal calprotectin is a potential biomarker for hypoxic intestinal damage in COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Role of fecal calprotectin as a hypoxic intestinal damage biomarker in COVID-19 patients

et al. 2022

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Background Gastrointestinal manifestations of coronavirus disease 2019 (COVID-19) appear to be substantial. Fecal calprotectin is a promising biomarker in COVID-19 associated gastrointestinal inflammation; however, its role in the severity of COVID-19 remains limited. We conducted a study to analyze the relationship between the severity of COVID-19 and hypoxic intestinal damage. Methods We assessed the severity of 44 hospitalized COVID-19 pneumonia patients based on the PaO2/FiO2 (P/F) ratio. Inflammatory markers were measured from blood samples, and fecal calprotectin was obtained from stool samples. Results Median levels of fecal calprotectin in COVID-19 patients involved in this study (n = 44) were found to be markedly elevated along with the severity of hypoxemia, as seen in the non-acute respiratory distress syndrome (ARDS) group 21.4 µg/g (5.2–120.9), mild ARDS 54.30 µg/g (5.2–1393.7), moderate ARDS 169.6 µg/g (43.4–640.5), and severe ARDS 451.6 µg/g (364.5–538.6). We also found significant differences in fecal calprotectin levels based on the severity of ARDS (P < 0.001), and although the patients were divided into ARDS and non-ARDS groups (P < 0.001). Furthermore, we found a strong negative correlation between the P/F ratio and fecal calprotectin levels (r = − 0.697, P < 0.001). Conclusion Our findings support the potential role of fecal calprotectin as a biomarker of intestinal inflammation in COVID-19 as a consequence of hypoxic intestinal damage and as suggested by the reduced P/F ratio.

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Calprotectin and SARS-CoV-2: A Brief-Report of the Current Literature

Cited by 9 publications

References 43 publications

Acute Mesenteric Ischemia in COVID-19 Patients

Acute Mesenteric Ischemia in COVID-19 Patients

Prognostic value of circulating calprotectin levels on the clinical course of COVID-19 differs between serum, heparin, EDTA and citrate sample types

Role of fecal calprotectin as a hypoxic intestinal damage biomarker in COVID-19 patients

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