Revista de enfermedades y trastornos inflamatorios del intestino

Can high calprotectin level predict mortality in patients with COVID-19?

Abstract

Maryam Sadat Mousavi*

Background: Some biomarkers such as C-reactive protein (CRP) and Fecal Calprotectin (FC) have been reported to be related to the prognosis of the coronavirus disease 2019 (COVID-19).

Methods: This case control study included 76 IBD patients in clinical remission and COVID-19 patients from December 2021 to March 2022. A checklist including demographic and clinical parameters was filled out for each participant. Two stool samples in 2 stages (during one month) and one blood sample were collected to test for FC and CRP, respectively. Data were analyzed using Wilcoxon, Mann Whitney, Spearman, T-test, ANOVA and K2 tests and P<0.05 was considered significant.

Results: 33 COVID-19 patients and 43 remission IBD cases with a mean age of 51.53 ± 15.155 years take part in the study. In COVID-19 group, mean FC ± SE in the first samples were 184.46 ± 59.01 (µg/g) and 144.58 ± 38.68 (µg/g) in the second samples one month later. In IBD patients in clinical remission mean FC in the first and in the second samples were 170.25 ± 42.23 (µg/g) and 204, 35 ± 68.33 (µg/g). The reduction in FC was significant among patients with COVID-19 (severe and moderate) after one month. 8 and 11 cases with COVID-19 and IBD had FC1 above or equal 200 (µg/g), respectively. Among 8 COVID-19 patients with high level FC1, 5 cases died. Mean CRP was 44.30 ± 3.47 in COVID-19 and 4.93 ± 1.00 in IBD patients (P<0.05). In cases, a correlation was seen between FC1 and CRP (rs=0.353, P=0.04).

Conclusion: Our findings showed gastrointestinal inflammation in COVID-19 patients even a month after recovery. More mortality was observed in patients with FC above 200. Higher level FC is presented in older COVID-19 patients that show the patients need special attention. Further studies are needed to understand the role of Calprotectin in predicting COVID-19 mortality.