Deasy Natalia Adriana and Titong Sugihartono and Iswan Abbas Nusi and Poernomo Boedi Setiawan and Herry Purbayu and Ummi Maimunah and Ulfa Kholili and Budi Widodo and Husin Thamrin and Amie Vidyani and Hasan Maulahela and Yoshio Yamaoka and Muhammad Miftahussurur (2022) Role of fecal calprotectin as a hypoxic intestinal damage biomarker in COVID-19 patients. Gut Pathogens, 14 (34). pp. 1-8. ISSN 1757-4749

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Abstract

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. Keywords: Fecal calprotectin, P/F ratio, COVID-19, Infectious disease

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