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).
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García de Guadiana-Romualdo Luis, Rodríguez Rojas Carlos, Morell-García Daniel, Andaluz-Ojeda David, Rodríguez Mulero María Dolores, Rodríguez-Borja Enrique, Ballesteros-Vizoso Antonieta, Calvo María Dolores, Albert-Botella Lourdes, Pozo Giráldez Adela, Llompart-Alabern Isabel, Bolado Jiménez Cristina, Hernández Olivo Marta, Fernández Presa Lucía, Ortega-Pérez Juan, Fora Romero María José, Campos-Rodríguez Valerio, Ballester Férriz Andrea, Guiu-Martí Alexandra M, Pinilla Arribas Leyre, Galindo Martínez María, Puerto-Lara Edwin R, López Tarazaga Ana Belen, Ros Braquehais María Salomé, Nogales Martín Leonor, Juez Santamaría Celia, Trapiello Fernández Wysalli, Espinilla Fernández Virginia, Havelka Aleksandra, Albaladejo-Otón María Dolores
Аннотация
METHODS: This was a multicenter prospective observational study enrolling consecutive adult COVID-19 patients. On arrival to emergency department, blood samples were collected for laboratory tests, including serum calprotectin. The primary outcome was severe respiratory failure requiring invasive mechanical ventilation and the secondary outcome was need for Intensive Care Unit (ICU) admission.
RESULTS: Study population included 395 patients, 57 (14.4%) required invasive mechanical ventilation and 100 (25.3%) were admitted to ICU. Median serum calprotectin levels were significantly higher in intubated (3.73 mg/L vs. 2.63 mg/L; p < 0.001) and ICU patients (3.48 mg/L vs. 2.60 mg/L; p = 0.001). Calprotectin showed a significant accuracy to predict the need for invasive mechanical ventilation (ROC AUC 0.723) and ICU admission (ROC AUC 0.650). In multivariate analysis, serum calprotectin was an independent predictor of invasive mechanical ventilation (OR 1.161) and ICU admission (OR 1.068).
CONCLUSION: Serum calprotectin can be used as an early predictor of severity in COVID-19 patients.