FAQ: What role can plasma & serum calprotectin play in severe COVID-19?

In our Frequently Asked Questions about calprotectin series we will answer questions we often receive about plasma and serum calprotectin and the Gentian Calprotectin Immunoassay GCAL^®. If you have any additional questions don't hesitate to contact us on marketing@gentian.com. 

In this section we will look into what role plasma and serum calprotectin can play in in severe COVID-19. 

Plasma and serum calprotectin in severe COVID-19

Severe form of COVID-19 has been characterised among others by, high involvement of neutrophils and hyperinflammatory host response leading to thrombotic complications, organ failure and mortality^1,2. Severe COVID-19 has also been described as viral sepsis. Since plasma and serum calprotectin is a neutrophil activation marker, described in bacterial infections and sepsis^3-6 it has gained attention in COVID-19 diagnostics. Indeed, several reports the value of calprotectin in early evaluation of disease severity and prediction of severe COVID-19^7-10.

Elevated calprotectin levels

Calprotectin levels are elevated in COVID-19 patients^2,8,9,11,12. Importantly, the levels have been significantly higher in severe COVID-19 cases compared to mild^{1,2,7-9,12-15} with correlation to:

• oxygenation status⁸
• need for mechanical ventilation⁸,
• intensive care unit (ICU) admission^1,9,13-15
• multiorgan failure (MOF)¹⁵ and
• mortality^1,7,9,13

Calprotectin has therefore also been described as a sensitive predictive marker for need of mechanical ventilation⁸, ICU admission^2,9,15, MOF¹⁵ and mortality^{1, 7, 9}.

Supporting the management of COVID-19 patients

Calprotectin (plasma and serum) can be used in the risk assessment and prediction of which COVID-19 patients are at risk of developing severe complications, and such help hospitals to better allocate essential resources that are often in limited supply. In conclusion, calprotectin measurements can aid in the triage of COVID-19 patients in times of limited resources, guide treatment decisions and improve overall patient outcome.

Calprotectin is elevated in patients with moderate and severe COVID-19 patients and can be used for:

• Differentiation between mild and severe form of the disease
• Early identification of patients at the risk to develop multiorgan failure including failure of the respiratory system
• Prediction of need for mechanical ventilation, ICU admission, organ failure and mortality
  
  

Get in touch 

For more details about the Gentian Calprotectin Immunoassay GCAL^®  please contact us at marketing@gentian.com or fill out the form below:

FAQ about plasma and serum calprotectin

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References

1. Barnes BJ et al. Targeting potential drivers of COVID-19: Neutrophil extracellular traps. J Exp Med. 2020.
2. Huang W et al. The Inflammatory Factors Associated with Disease Severity to Predict COVID-19 Progression. J Immunol. 2021.
3. Wirtz TH et al. Association of Serum Calprotectin Concentrations with Mortality in Critically Ill and Septic Patients. Diagnostics (Basel). 2020.
4. Larsson A et al. Calprotectin is superior to procalcitonin as a sepsis marker and predictor of 30-day mortality in intensive care patients. Scandinavian Journal of Clinical and Laboratory Investigation. 2019.
5. Simm M et al. Performance of plasma calprotectin as a biomarker of early sepsis: a pilot study. Biomark Med. 2016.
6. Gao S et al. Diagnostic and prognostic value of myeloid-related protein complex 8/14 for sepsis. Am J Emerg Med. 2015;33(9):1278-82.
7. Luis García de Guadiana R et al. Circulating levels of GDF-15 and calprotectin for prediction of in-hospital mortality in COVID-19 patients: A case series. J Infect. 2020.
8. Shi H et al. Neutrophil calprotectin identifies severe pulmonary disease in COVID-19. Journal of Leukocyte Biology. 2020.
9. 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.
10. Udeh R et al. Calprotectin, an Emerging Biomarker of Interest in COVID-19: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021.
11. Wu M et al. Transcriptional and proteomic insights into the host response in fatal COVID-19 cases. Proc Natl Acad Sci U S A. 2020.
12. Shu T et al. Plasma Proteomics Identify Biomarkers and Pathogenesis of COVID-19. Immunity. 2020.
13. Silvin A et aø. Elevated Calprotectin and Abnormal Myeloid Cell Subsets Discriminate Severe from Mild COVID-19. Cell. 2020.
14. Sohn KM et al. COVID-19 Patients Upregulate Toll-like Receptor 4-mediated Inflammatory Signaling That Mimics Bacterial Sepsis. J Korean Med Sci. 2020.
15. Bauer W et al. Outcome prediction by serum calprotectin in patients with COVID-19 in the emergency department. J Infect. 2020.