Circulating levels of calprotectin, a signature of neutrophil activation in prediction of severe respiratory failure in COVID-19 patients: a multicenter, prospective study (CalCov study)

Published on
Journal: Inflammation research : official journal of the Eu
[저자] Luis García de Guadiana-Romualdo, Carlos Rodríguez Rojas, Daniel Morell-García, David Andaluz-Ojeda, María Dolores Rodríguez Mulero, Enrique Rodríguez-Borja, Antonieta Ballesteros-Vizoso, María Dolores Calvo, Lourdes Albert-Botella, Adela Pozo Giráldez, Isabel Llompart-Alabern, Cristina Bolado Jiménez, Marta Hernández Olivo, Lucía Fernández Presa, Juan Ortega-Pérez, María José Fora Romero, Valerio Campos-Rodríguez, Andrea Ballester Férriz, Alexandra M Guiu-Martí, Leyre Pinilla Arribas, María Galindo Martínez, Edwin R Puerto-Lara, Ana Belen López Tarazaga, María Salomé Ros Braquehais, Leonor Nogales Martín, Celia Juez Santamaría, Wysalli Trapiello Fernández, Virginia Espinilla Fernández, Aleksandra Havelka, María Dolores Albaladejo-Otón
[Category] 임상,
PMC URL    [DOI] 10.1007/s00011-021-01516-4    
[Article Type] Observational Study
[Source] PMC

Abstract
Objective: Severe COVID-19 is characterized by a dysregulated immune response in which neutrophils play a critical role. Calprotectin reflects neutrophil activation and is involved in the self-amplifying thrombo-inflammatory storm in severe COVID-19. We aimed to evaluate the role of calprotectin in early prediction of severity in COVID-19 patients.
Methods: This was a multicenter prospective observational study enrolling consecutive adult COVID-19 patients. On arrival to emergency department, blood samples were collected for laboratory tests, including serum calprotectin. The primary outcome was severe respiratory failure requiring invasive mechanical ventilation and the secondary outcome was need for Intensive Care Unit (ICU) admission.
Results: Study population included 395 patients, 57 (14.4%) required invasive mechanical ventilation and 100 (25.3%) were admitted to ICU. Median serum calprotectin levels were significantly higher in intubated (3.73 mg/L vs. 2.63 mg/L; p < 0.001) and ICU patients (3.48 mg/L vs. 2.60 mg/L; p = 0.001). Calprotectin showed a significant accuracy to predict the need for invasive mechanical ventilation (ROC AUC 0.723) and ICU admission (ROC AUC 0.650). In multivariate analysis, serum calprotectin was an independent predictor of invasive mechanical ventilation (OR 1.161) and ICU admission (OR 1.068).
Conclusion: Serum calprotectin can be used as an early predictor of severity in COVID-19 patients.
Keywords: COVID-19; Calprotectin; ICU admission; Invasive mechanical ventilation; Neutrophil activation.

All Keywords
【저자키워드】 COVID-19, ICU admission, calprotectin, Invasive mechanical ventilation, Neutrophil activation., 【초록키워드】 severe COVID-19, prospective observational study, severity, severe respiratory failure, neutrophil, intensive care unit, Laboratory tests, ICU, serum, Accuracy, multicenter, Admission, Critical, patients, predict, COVID-19 patients, Analysis, neutrophil activation, Activation, Intubated, Primary outcome, blood sample, secondary outcome, dysregulated immune response, ROC AUC, adult COVID-19 patients, ICU patient, independent, collected, evaluate, involved, required, characterized, can be used, significantly higher, reflect, admitted to ICU, 【제목키워드】 Prospective Study, severe respiratory failure, multicenter, neutrophil activation,