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J Leukoc Biol . Neutrophil calprotectin identifies severe pulmonary disease in COVID-19

tetano

Editor, Senior Moderator
J Leukoc Biol


. 2020 Sep 1.
doi: 10.1002/JLB.3COVCRA0720-359R. Online ahead of print.
Neutrophil calprotectin identifies severe pulmonary disease in COVID-19


Hui Shi[SUP] 1 2 [/SUP], Yu Zuo[SUP] 1 [/SUP], Srilakshmi Yalavarthi[SUP] 1 [/SUP], Kelsey Gockman[SUP] 1 [/SUP], Melanie Zuo[SUP] 3 [/SUP], Jacqueline A Madison[SUP] 1 [/SUP], Christopher Blair[SUP] 4 [/SUP], Wrenn Woodward[SUP] 5 [/SUP], Sean P Lezak[SUP] 5 [/SUP], Njira L Lugogo[SUP] 6 [/SUP], Robert J Woods[SUP] 4 [/SUP], Christian Lood[SUP] 7 [/SUP], Jason S Knight[SUP] 1 [/SUP], Yogendra Kanthi[SUP] 8 9 [/SUP]



Affiliations

Abstract

Severe cases of coronavirus disease 2019 (COVID-19) are regularly complicated by respiratory failure. Although it has been suggested that elevated levels of blood neutrophils associate with worsening oxygenation in COVID-19, it is unknown whether neutrophils are drivers of the thrombo-inflammatory storm or simple bystanders. To better understand the potential role of neutrophils in COVID-19, we measured levels of the neutrophil activation marker S100A8/A9 (calprotectin) in hospitalized patients and determined its relationship to severity of illness and respiratory status. Patients with COVID-19 (n = 172) had markedly elevated levels of calprotectin in their blood. Calprotectin tracked with other acute phase reactants including C-reactive protein, ferritin, lactate dehydrogenase, and absolute neutrophil count, but was superior in identifying patients requiring mechanical ventilation. In longitudinal samples, calprotectin rose as oxygenation worsened. When tested on day 1 or 2 of hospitalization (n = 94 patients), calprotectin levels were significantly higher in patients who progressed to severe COVID-19 requiring mechanical ventilation (8039 ? 7031 ng/ml, n = 32) as compared to those who remained free of intubation (3365 ? 3146, P < 0.0001). In summary, serum calprotectin levels track closely with current and future COVID-19 severity, implicating neutrophils as potential perpetuators of inflammation and respiratory compromise in COVID-19.

Keywords: COVID-19; SARS-CoV-2; calprotectin; neutrophil extracellular traps; neutrophils.
 
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