Calprotectin Levels and Neutrophil Count Are Prognostic Markers of Mortality in COVID-19 Patients

Cardiero, Giovanna; Palma, D. De; Vano, Martina; Anastasio, Claudia; Pinchera, Biagio; Ferrandino, Martina; Gianfico, Carlo; Gentile, Luca; Savoia, Marcella; Gentile, Ivan; Taranto, Maria Donata Di; Fortunato, Giuliana

doi:10.3390/diagnostics12102554

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Since there was no sufficient data of serum or plasma calprotectin, six others studies were also considered ineligible for this meta‐analysis. Finally, 15 studies 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 involving 2753 patients were included in the quantitative analysis. Among the 15 studies, 11 24 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 38 assessed the diagnostic value of calprotectin, five 25 , 31 , 34 , 35 , 36 reported the mortality and eight 24 , 27 , 29 , 30 , 32 , 35 , 36 , 37 presented the level of calprotectin.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, 15 studies 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 involving 2753 patients were included in the quantitative analysis. Among the 15 studies, 11 24 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 38 assessed the diagnostic value of calprotectin, five 25 , 31 , 34 , 35 , 36 reported the mortality and eight 24 , 27 , 29 , 30 , 32 , 35 , 36 , 37 presented the level of calprotectin. The methods used to detect calprotectin in all 15 studies were enzyme‐linked immunosorbent assay (ELISA), chemiluminescent immunoassay, turbidimetric assay, and quantitative reverse‐transcription polymerase chain reaction (RT‐qPCR).…”

Section: Resultsmentioning

confidence: 99%

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Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID‐19

Zhang,

Liu

et al. 2024

Immunity Inflam & Disease

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BackgroundPatients with coronavirus disease‐2019 (COVID‐19) are characterized by hyperinflammation. Calprotectin (S100A8/S100A9) is a calcium‐ and zinc‐binding protein mainly secreted by neutrophilic granulocytes or macrophages and has been suggested to be correlated with the severity and prognosis of COVID‐19.AimTo thoroughly evaluate the diagnostic and prognostic utility of calprotectin in patients with COVID‐19 by analyzing relevant studies.MethodsPubMed, Web of Science, and Cochrane Library were comprehensively searched from inception to August 1, 2023 to retrieve studies about the application of calprotectin in COVID‐19. Useful data such as the level of calprotectin in different groups and the diagnostic efficacy of this biomarker for severe COVID‐19 were extracted and aggregated by using Stata 16.0 software.ResultsFifteen studies were brought into this meta‐analysis. First, the pooled standardized mean differences (SMDs) were used to estimate the differences in the levels of circulating calprotectin between patients with severe and non‐severe COVID‐19. The results showed an overall estimate of 1.84 (95% confidence interval [CI]: 1.09–2.60). Diagnostic information was extracted from 11 studies, and the pooled sensitivity and specificity of calprotectin for diagnosing severe COVID‐19 were 0.75 (95% CI: 0.64–0.84) and 0.88 (95% CI: 0.79–0.94), respectively. The AUC was 0.89 and the pooled DOR was 18.44 (95% CI: 9.07–37.51). Furthermore, there was a strong correlation between elevated levels of circulating calprotectin and a higher risk of mortality outcomes in COVID‐19 patients (odds ratio: 8.60, 95% CI: 2.17–34.12; p < 0.1).ConclusionThis meta‐analysis showed that calprotectin was elevated in patients with severe COVID‐19, and this atypical inflammatory cytokine might serve as a useful biomarker to distinguish the severity of COVID‐19 and predict the prognosis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID‐19

Zhang,

Liu

et al. 2024

Immunity Inflam & Disease

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“…Elevated monocytes counts were independently associated with mortality in severe sepsis 37 . High neutrophils served as a predictor of death in ICU patients 38 . Increased circulating immature granulocytes were related to worsening sepsis at the acute phase 39 .…”

Section: Discussionmentioning

confidence: 99%

Basophils absence predicts poor prognosis and indicates immunosuppression of patients in intensive care units

Chen,

Zhu,

Zhuo

et al. 2023

Sci Rep

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Immune cells and immunity are associated with the prognosis of patients with critical illness. Here, medical records retrospectively extracted from the Medical Information Mart for Intensive Care IV were used for screening an immune-related biomarker in intensive care units (ICU) patients and applied for validating the identified indicator in septic patients. In this work, the count of innate immune cells, basophils, harbored a superior role in predicting ICU patients’ prognosis compared with those of other blood immune cells (OR 0.013, 95% CI 0.001, 0.118, P < 0.001). Importantly, basophils absence during ICU stay was positively correlated with the 28-day mortality of ICU patients and served as an independent predictor of ICU patients’ prognosis (OR 3.425, 95% CI 3.717–3.165, P < 0.001). Moreover, the association between critical illness progression, poor outcome, and basophils absence was verified in septic patients. Subsequent investigations revealed the positive relationship between basophils absence and immunosuppression, and suggested the potential of basophils-mediated immunity in predicting the 28-day mortality of ICU patients. Collectively, we identify basophils absence during ICU stay as a novel and unfavorable indicator for evaluating the prognosis of ICU patients and recognizing a branch of ICU patients potentially suitable for intensified treatment and immunoenhancement therapy.

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“…Calprotectin has also been shown to be a promising biomarker for estimation of disease severity, prediction of organ failure, and mortality in patients with severe infections, including bacterial infections and SARS-CoV-2 infections presented at the emergency department as well as in an ICU setting [ 24 , 27 , 28 , 29 ]. Unlike other routinely used inflammatory biomarkers, such as CRP and PCT, calprotectin is released by neutrophils into the bloodstream without requiring de novo protein biosynthesis [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Calprotectin as an Early Marker of Infections Is Economically Advantageous in Intensive Care-Treated Patients

Havelka,

Larsson,

Mårtensson

et al. 2023

Biomedicines

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Calprotectin is released from neutrophil granulocytes upon activation. Several studies have indicated that plasma calprotectin is an early determinant of bacterial infections, which may serve as a diagnostic tool facilitating decision making on antibiotic treatment. The study objective was to explore the health and economic implications of calprotectin as a predictive tool to initiate antimicrobial therapy in a cohort of critically ill patients. Thus, data obtained from a previously published study on calprotectin as a hypothetical early biomarker of bacterial infections in critically ill patients were evaluated regarding the potential cost-effective impact of early analysis of calprotectin on an earlier start of antibiotic treatment. Under the assumption that calprotectin is used predictively and comparators (white blood cells, procalcitonin, and C-reactive protein) are used diagnostically, a cost-effective impact of EUR 11,000–12,000 per patient would be obtained. If calprotectin would be used predictively and comparators would be used predictively for 50% of patients, it is hypothesized that cost-effectiveness would be between EUR 6000 and 7000 per patient, based on reduced stay in the ICU and general ward, respectively. Furthermore, predictive use of calprotectin seems to reduce both mortality and the length of hospital stay. This health economic analysis on the predictive use of plasma calprotectin, which facilitates clinical decision making in cases of suspected sepsis, indicates that such determination has a cost-saving and life-saving impact on the healthcare system.

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Calprotectin Levels and Neutrophil Count Are Prognostic Markers of Mortality in COVID-19 Patients

Cited by 9 publications

References 35 publications

Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID‐19

Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID‐19

Basophils absence predicts poor prognosis and indicates immunosuppression of patients in intensive care units

Analysis of Calprotectin as an Early Marker of Infections Is Economically Advantageous in Intensive Care-Treated Patients

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