Association of Serum Calprotectin Concentrations with Mortality in Critically Ill and Septic Patients

Abstract

Background: Calprotectin is present in the cytosol of neutrophil granulocytes and released upon activation. Fecal calprotectin is applied in the clinical management of inflammatory bowel disease whereas serum calprotectin has been discussed as a biomarker in inflammatory disorders. However, its long-term prognostic relevance in critical illness remains unclear. Our aim was to investigate serum calprotectin concentrations as a prognostic biomarker in critically ill and septic patients. Methods: Serum calprotectin concentrations were analyzed in 165 critically ill patients (108 with sepsis, 57 without sepsis) included in our observational study. Patients were enrolled upon admission to the medical intensive care unit (ICU) of the RWTH Aachen University Hospital. Calprotectin concentrations were compared to 24 healthy controls and correlated with clinical parameters, therapeutic interventions, and survival. Results: Serum calprotectin concentrations were significantly increased in ICU patients as well as in septic patients compared to respective controls (p < 0.001 for ICU patients and p = 0.001 for septic patients). Lower calprotectin concentrations were measured in patients with comorbidities i.e., coronary artery disease. Calprotectin concentrations strongly correlated with the C-reactive protein (p < 0.001) and were closely associated to parameters of mechanical ventilation (i.a. inspiratory oxygen fraction, FiO2; p < 0.001). The overall survival was significantly impaired in septic patients with high baseline calprotectin concentrations (p = 0.036). However, patients with increasing calprotectin serum concentrations within the first week of ICU admission showed an improved overall survival (p = 0.009). Conclusions: In summary, serum calprotectin concentrations are significantly increased in critically ill patients with sepsis. High calprotectin concentrations at ICU admission predict long-term mortality risk, whereas increasing calprotectin concentrations are associated with a favorable long-term outcome.

Association between Calprotectin and Cystatin C levels with kidney injury Molecule-1 and their effects on developments of COVID-19 complications

“…It has recently been reported that calprotectin can be used as a biomarker of inflammation for assessing the activity of some inflammatory disorders. 34 In addition, according to that study, a significant elevation of serum calprotectin was associated with high mortality in Covid-19 patients. 35 Studies are ongoing, but there is not enough evidence at this time to support this finding and no scientific consensus whether calprotectin can serve as a prediction of how serious the virus will be in some patients.…”

In Search of Clinical Markers: Indicators of Exposure in Dampness and Mold Hypersensitivity Syndrome (DMHS)

“…In patients with SARS-COVID-19 infection receiving treatment in an intensive care unit, the ROC assay results indicated that MRP8/14 was superior to other markers (ferritin, CRP, lactate dehydrogenase) in evaluations of the patient’s health status [ 54 ]. Wirtz reported that mortality of SARS-COVID-19 patients in intensive care units was related to a reduction in MRP8/14 levels, whereas the surviving subjects had increased MRP8/14 levels [ 55 ]. This could explain the finding of lower MRP8/14 concentrations in exposed men vs. the men in the control group.…”

Role of cystatin C and calprotectin as potential early prognostic biomarkers in COVID-19 patients admitted to a dedicated COVID care facility

“…[ 13 14 ] Conditions other than COVID-19 have also showed elevated serum calprotectin levels like critically ill patients, critical patients with sepsis, and is associated with renal and respiratory dysfunction and predicts long term mortality risk. [ 28 29 ] Another study showed higher levels in COVID-19 patients requiring mechanical ventilation. [ 20 ] These observations and the fact that calprotectin was raised in deceased patients [ Table 2 ] in our study suggest its possible role in prediction of critical illness and death.…”