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

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 

机构地区：[1]Infectious Diseases Unit,Trieste University Hospital(ASUGI),Trieste 34125,Italy [2]Infectious Diseases Unit,Clinical Department of Medical,Surgical and Health Sciences,Trieste University,Trieste 34123,Italy [3]Liver Unit,Clinical Department of Medical,Surgical and Health Sciences,Trieste University,Trieste 34127,Italy [4]Department of Life Sciences,Trieste University,Trieste 34127,Italy [5]Department of Hygiene and Public Health Unit,Trieste University Hospital(ASUGI),Trieste 34125,Italy [6]Division of Laboratory Medicine,Trieste University Hospital(ASUGI),Trieste 34125,Italy

出　　处：《World Journal of Gastroenterology》2021年第22期3130-3137,共8页世界胃肠病学杂志（英文版）

基　　金：This study was conducted according to the declaration of Helsinki and approved by the Ethics Committee(Unique Regional Ethical Committee,Friuli Venezia-Giulia 16 April 2020),No.CEUR 2020-OS-072.

摘　　要：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 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 

分 类 号：R563.1[医药卫生—呼吸系统] R57[医药卫生—内科学]