Background: Although fecal calprotectin has prognostic value in assessing inflammatory bowel disease, the relationship of fecal calprotectin level with the severity of COVID-19 disease has not been determined yet. This study aimed to determine if fecal calprotectin may be used as a marker for the severity of COVID-19 disease.
Patients and Methods: A total of 50 patients with COVID-19 disease who presented with gastrointestinal manifestations, with or without respiratory manifestations and other symptoms, were categorized into four groups: 14 patients with mild symptoms, 12 patients with moderate manifestations, 12 patients with severe manifestations, and 12 critically ill patients in the intensive care unit (ICU). Fecal calprotectin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), D-dimer, ferritin, and complete blood count (CBC) were measured at baseline and after 21 days, along with clinical follow-up.
Results: A substantial decrease in fecal calprotectin levels from baseline to 21 days across all cases and subgroups. Notably, critical patients exhibited significantly higher fecal calprotectin levels compared to severe, moderate, and mild cases at baseline and after 21 days (p-value <0.001). Additionally, critical patients had significantly elevated ESR, CRP, ferritin, and D-dimer levels compared to other groups. The duration of hospitalization was significantly longer for vital and severe patients compared to moderate and mild cases. Furthermore, the mortality rate within 21 days was significantly higher in critical and severe cases compared to other groups.
Conclusion: Our findings indicate a substantial correlation between fecal calprotectin levels and the severity of COVID-19. Notably, fecal calprotectin levels were considerably higher in the critical group compared to other groups, both at baseline and after 21 days. So, fecal calprotectin may be used as a marker for the severity of COVID-19 disease.