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High fecal calprotectin levels are associated with SARS-CoV-2 intestinal shedding in COVID-19 patients:A proof-of-concept study

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World Journal of Gastroenterology 2021年第22期27卷 3130-3137页

作者： Verena Zerbato Stefano Di Bella Mauro Giuffrè Anna Wladyslawa Jaracz Ylenia Gobbo Diego Luppino Paolo Macor Ludovica Segat Raffaella Koncan Pierlanfranco D'Agaro Michael Valentini Lory Saveria Crocé Maurizio Ruscio roberto luzzati Infectious Diseases Unit Trieste University Hospital(ASUGI)Trieste 34125Italy Infectious Diseases Unit Clinical Department of MedicalSurgical and Health SciencesTrieste UniversityTrieste 34123Italy Liver Unit Clinical Department of MedicalSurgical and Health SciencesTrieste UniversityTrieste 34127Italy Department of Life Sciences Trieste UniversityTrieste 34127Italy Department of Hygiene and Public Health Unit Trieste University Hospital(ASUGI)Trieste 34125Italy Division of Laboratory Medicine Trieste University Hospital(ASUGI)Trieste 34125Italy

BACKGROUND One third of coronavirus disease 2019(COVID-19)patients have gastrointestinal *** acute respiratory syndrome coronavirus 2(SARS-CoV-2)RNA has been detected in stool samples of approximately 50%of COVID-19 *** calprotectin is a marker of gastrointestinal inflammation in the general *** To investigate if fecal calprotectin correlates with SARS-CoV-2 intestinal shedding in COVID-19 patients with *** 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 *** 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 *** We enrolled 51 adults(40 males)with SARS-CoV-2 *** patients(20%)presented with ***-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 *** was one of the most common comorbidities(13 patients,25%);all obese patients(100%)(P=0.021)tested positive for fecal *** 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 SARSCoV-2 detection in stools supporting the hypothesis that this virus can lead to bowel inflammation and potentially to the‘leaky gut’syndrome.

关键词： COVID-19 SARS-CoV-2 Obesity Fecal calprotectin Gut Viral shedding

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