Elevated level of circulating calprotectin correlates with severity and high mortality in patients with COVID‐19
Haoran Zhang, Qingyu Zhang, Kun Liu, Zenong Yuan, Xiqiang Xu, Jun Dong- Immunology
- Immunology and Allergy
Abstract
Background
Patients with coronavirus disease‐2019 (COVID‐19) are characterized by hyperinflammation. Calprotectin (S100A8/S100A9) is a calcium‐ and zinc‐binding protein mainly secreted by neutrophilic granulocytes or macrophages and has been suggested to be correlated with the severity and prognosis of COVID‐19.
Aim
To thoroughly evaluate the diagnostic and prognostic utility of calprotectin in patients with COVID‐19 by analyzing relevant studies.
Methods
PubMed, Web of Science, and Cochrane Library were comprehensively searched from inception to August 1, 2023 to retrieve studies about the application of calprotectin in COVID‐19. Useful data such as the level of calprotectin in different groups and the diagnostic efficacy of this biomarker for severe COVID‐19 were extracted and aggregated by using Stata 16.0 software.
Results
Fifteen studies were brought into this meta‐analysis. First, the pooled standardized mean differences (SMDs) were used to estimate the differences in the levels of circulating calprotectin between patients with severe and non‐severe COVID‐19. The results showed an overall estimate of 1.84 (95% confidence interval [CI]: 1.09–2.60). Diagnostic information was extracted from 11 studies, and the pooled sensitivity and specificity of calprotectin for diagnosing severe COVID‐19 were 0.75 (95% CI: 0.64–0.84) and 0.88 (95% CI: 0.79–0.94), respectively. The AUC was 0.89 and the pooled DOR was 18.44 (95% CI: 9.07–37.51). Furthermore, there was a strong correlation between elevated levels of circulating calprotectin and a higher risk of mortality outcomes in COVID‐19 patients (odds ratio: 8.60, 95% CI: 2.17–34.12; p < 0.1).
Conclusion
This meta‐analysis showed that calprotectin was elevated in patients with severe COVID‐19, and this atypical inflammatory cytokine might serve as a useful biomarker to distinguish the severity of COVID‐19 and predict the prognosis.