New study results from two COVID-19 studies have recently been published. The CASCADE trail study in collaboration with Charité – Universitätsmedizin Berlin and Labor Berlin has published first results in a poster at the European Society for Emergency Medicine (EUSEM) congress in Lisbon. The CalCov study, a multicentre study in collaboration with four hospitals in Spain, has published their final results in the scientific journal “Inflammation Research”.
Plasma calprotectin as a novel biomarker in COVID-19 in emergency medicine: Preliminary results of the ongoing CASCADE trial
The first results from this study are part of an ongoing prospective clinical trial (CASCADE), which is performed in the Emergency department of the Charité – Universitätsmedizin Berlin Campus Benjamin Franklin.
The poster presented results from 10 COVID-19 patients, focusing on the predictive value of calprotectin for ICU admission and need for mechanical ventilation. The calprotectin levels in plasma were significantly higher in ventilated than in non-ventilated COVID-19 patients. Moreover, calprotectin was able to predict need for Intensive Care Unit (ICU) admission, with outstanding performance and an AUROC of 1.0. The performance of calprotectin in prediction of ICU admission was better than performance of the biomarker procalcitonin. For further information please see the enclosed poster.
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)
This study included 395 patients from the second wave of COVID-19 in Spain (September to November 2020) with confirmed SARS-CoV-2 infection.
Calprotectin levels were significantly increased in patients which required invasive mechanical ventilation, ICU admission and also for the subpopulation of ICU patients requiring invasive mechanical ventilation. Univariate and multivariate regression analyses confirmed that calprotectin is an independent predictor of need for invasive mechanical ventilation and ICU admission. In addition, ROC analyses have shown calprotectin as a predictor for the need of invasive mechanical ventilation, ICU admission as well as for the need of invasive mechanical ventilation in the ICU subpopulation. For further information please see the enclosed research paper. The results confirmed the discriminatory value described in a previous smaller study with 66 COVID-19 patients in the first wave in Spain1.
Calprotectin’s role in risk stratification and estimation of disease severity in COVID-19
The conclusion from both studies supports calprotectin as an early biomarker for risk stratification and optimal management of COVID-19 patients. Early identification of patients with severe form of the disease is of critical importance for optimal patient care and use of healthcare resources. The assessment of calprotectin in combination with other clinical data can be useful for fast triage, timely allocation and effective care of COVID-19 patients.
The results from these two studies are in line with several previous reports of calprotectin as risk stratification of disease severity regarding the need for mechanical ventilation, ICU admission, multi organ failure and mortality1-8.
Gentian Calprotectin GCAL® Immunoassay - early access to accurate results
GCAL® can be used for early detection and assessment of the inflammatory response to severe infections, where it is critical to get access to the results as soon as possible. Since GCAL® is a Particle-Enhanced Turbidimetric Immunoassay (PETIA), the assay is rapidly performed in only 10 minutes.
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References:
- de Guadiana Romualdo LG et al. Circulating levels of GDF-15 and calprotectin for prediction of in-hospital mortality in COVID-19 patients: a case series. Journal of Infection. 2020
- Bauer et al. Outcome prediction by serum calprotectin in patients with COVID-19 in the emergency department. Journal of Infection. 2020
- Shi H et al. Neutrophil calprotectin identifies severe pulmonary disease in COVID-19. Journal of Leukocyte Biology. 2020
- Silvin et al. Elevated calprotectin and abnormal myeloid cell subsets discriminate severe from mild COVID-19. Cell. 2020
- Sohn KM et al. COVID-19 Patients Upregulate Toll-like Receptor 4-mediated Inflammatory Signaling That Mimics Bacterial Sepsis. J Korean Med Sci. 2020
- Wu M et al. Transcriptional and proteomic insights into the host response in fatal COVID-19 cases. PNAS. 2020
- Chen L et al. Elevated serum levels of S100A8/A9 and HMGB1 at hospital admission are correlated with inferior clinical outcomes in COVID-19 patients. Cell Mol Immunol. 2020
- Udeh R et al. Calprotectin, an Emerging Biomarker of Interest in COVID-19: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021
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