Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3130
Peer-review started: February 7, 2021
First decision: February 27, 2021
Revised: March 12, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: June 14, 2021
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.
The pathogenesis of gastrointestinal symptoms caused by SARS-CoV-2 is multifactorial and little evidence is available on this topic.
To investigate whether fecal calprotectin correlates with SARS-CoV-2 intestinal shedding in COVID-19 patients with pneumonia.
Fecal samples from patients with SARS-CoV-2 pneumonia were collected and analyzed for quantification of fecal calprotectin and SARS-CoV-2 RNA presence using polymerase chain reaction (PCR).
Real-time-PCR of SARS-CoV-2 in the stools of 51 patients with pneumonia was positive in 39 patients (76%), in all patients with diarrhea (100%) and in more than two thirds (29/41, 71%) of those without diarrhea. Higher fecal calprotectin levels were found in the group with SARS-CoV-2 in stools [74 mg/kg, interquartile range (IQR) 29; 132.5] compared to the group without SARS-CoV-2 (39 mg/kg, IQR 14; 71) (P < 0.001).
High fecal calprotectin levels in COVID-19 patients correlates with SARS-CoV-2 detection in stools.
Our results support the hypothesis that SARS-CoV-2-induced intestinal damage mediated by innate immunity could contribute to COVID-19 pathogenesis.