tetano
Editor, Senior Moderator
World J Gastroenterol
. 2021 Jun 14;27(22):3130-3137.
doi: 10.3748/wjg.v27.i22.3130.
High fecal calprotectin levels are associated with SARS-CoV-2 intestinal shedding in COVID-19 patients: A proof-of-concept study
Verena Zerbato[SUP] 1 [/SUP], Stefano Di Bella[SUP] 2 [/SUP], Mauro Giuffrè[SUP] 3 [/SUP], Anna Wladyslawa Jaracz[SUP] 1 [/SUP], Ylenia Gobbo[SUP] 1 [/SUP], Diego Luppino[SUP] 1 [/SUP], Paolo Macor[SUP] 4 [/SUP], Ludovica Segat[SUP] 5 [/SUP], Raffaella Koncan[SUP] 5 [/SUP], Pierlanfranco D'Agaro[SUP] 5 [/SUP], Michael Valentini[SUP] 1 [/SUP], Lory Saveria Crocé[SUP] 3 [/SUP], Maurizio Ruscio[SUP] 6 [/SUP], Roberto Luzzati[SUP] 7 [/SUP]
Affiliations
Abstract
Background: One third of coronavirus disease 2019 (COVID-19) patients have gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA has been detected in stool samples of approximately 50% of COVID-19 individuals. Fecal calprotectin is a marker of gastrointestinal inflammation in the general population.
Aim: To investigate if fecal calprotectin correlates with SARS-CoV-2 intestinal shedding in COVID-19 patients with pneumonia.
Methods: Patients with SARS-CoV-2 pneumonia admitted to the Infectious Disease Unit (University Hospital of Trieste, Italy) from September to November 2020 were consecutively enrolled in the study. Fecal samples were collected and analyzed for quantification of fecal calprotectin (normal value < 50 mg/kg) and SARS-CoV-2 RNA presence by polymerase chain reaction (PCR). Inter-group differences were determined between patients with and without diarrhea and patients with and without detection of fecal SARS-CoV-2.
Results: We enrolled 51 adults (40 males) with SARS-CoV-2 pneumonia. Ten patients (20%) presented with diarrhea. Real-time-PCR of SARS-CoV-2 in stools was positive in 39 patients (76%), in all patients with diarrhea (100%) and in more than two thirds (29/41, 71%) of patients without diarrhea. Obesity was one of the most common comorbidities (13 patients, 25%); all obese patients (100%) (P = 0.021) tested positive for fecal SARS-CoV-2. Median fecal calprotectin levels were 60 mg/kg [interquartile range (IQR) 21; 108]; higher fecal calprotectin levels were found in the group with SARS-CoV-2 in stools (74 mg/kg, IQR 29; 132.5) compared to the group without SARS-CoV-2 (39 mg/kg, IQR 14; 71) (P < 0.001).
Conclusion: High fecal calprotectin levels among COVID-19 patients correlate with SARS-CoV-2 detection in stools supporting the hypothesis that this virus can lead to bowel inflammation and potentially to the 'leaky gut' syndrome.
Keywords: COVID-19; Fecal calprotectin; Gut; Obesity; SARS-CoV-2; Viral shedding.
. 2021 Jun 14;27(22):3130-3137.
doi: 10.3748/wjg.v27.i22.3130.
High fecal calprotectin levels are associated with SARS-CoV-2 intestinal shedding in COVID-19 patients: A proof-of-concept study
Verena Zerbato[SUP] 1 [/SUP], Stefano Di Bella[SUP] 2 [/SUP], Mauro Giuffrè[SUP] 3 [/SUP], Anna Wladyslawa Jaracz[SUP] 1 [/SUP], Ylenia Gobbo[SUP] 1 [/SUP], Diego Luppino[SUP] 1 [/SUP], Paolo Macor[SUP] 4 [/SUP], Ludovica Segat[SUP] 5 [/SUP], Raffaella Koncan[SUP] 5 [/SUP], Pierlanfranco D'Agaro[SUP] 5 [/SUP], Michael Valentini[SUP] 1 [/SUP], Lory Saveria Crocé[SUP] 3 [/SUP], Maurizio Ruscio[SUP] 6 [/SUP], Roberto Luzzati[SUP] 7 [/SUP]
Affiliations
- PMID: 34168414
- PMCID: PMC8192288
- DOI: 10.3748/wjg.v27.i22.3130
Abstract
Background: One third of coronavirus disease 2019 (COVID-19) patients have gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA has been detected in stool samples of approximately 50% of COVID-19 individuals. Fecal calprotectin is a marker of gastrointestinal inflammation in the general population.
Aim: To investigate if fecal calprotectin correlates with SARS-CoV-2 intestinal shedding in COVID-19 patients with pneumonia.
Methods: Patients with SARS-CoV-2 pneumonia admitted to the Infectious Disease Unit (University Hospital of Trieste, Italy) from September to November 2020 were consecutively enrolled in the study. Fecal samples were collected and analyzed for quantification of fecal calprotectin (normal value < 50 mg/kg) and SARS-CoV-2 RNA presence by polymerase chain reaction (PCR). Inter-group differences were determined between patients with and without diarrhea and patients with and without detection of fecal SARS-CoV-2.
Results: We enrolled 51 adults (40 males) with SARS-CoV-2 pneumonia. Ten patients (20%) presented with diarrhea. Real-time-PCR of SARS-CoV-2 in stools was positive in 39 patients (76%), in all patients with diarrhea (100%) and in more than two thirds (29/41, 71%) of patients without diarrhea. Obesity was one of the most common comorbidities (13 patients, 25%); all obese patients (100%) (P = 0.021) tested positive for fecal SARS-CoV-2. Median fecal calprotectin levels were 60 mg/kg [interquartile range (IQR) 21; 108]; higher fecal calprotectin levels were found in the group with SARS-CoV-2 in stools (74 mg/kg, IQR 29; 132.5) compared to the group without SARS-CoV-2 (39 mg/kg, IQR 14; 71) (P < 0.001).
Conclusion: High fecal calprotectin levels among COVID-19 patients correlate with SARS-CoV-2 detection in stools supporting the hypothesis that this virus can lead to bowel inflammation and potentially to the 'leaky gut' syndrome.
Keywords: COVID-19; Fecal calprotectin; Gut; Obesity; SARS-CoV-2; Viral shedding.