BackgroundPatients 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.AimTo thoroughly evaluate the diagnostic and prognostic utility of calprotectin in patients with COVID‐19 by analyzing relevant studies.MethodsPubMed, 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.ResultsFifteen 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).ConclusionThis 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.

中文翻译：

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循环钙卫蛋白水平升高与 COVID-19 患者的严重程度和高死亡率相关

背景 2019 年冠状病毒病 (COVID-19) 患者的特点是过度炎症。钙卫蛋白 (S100A8/S100A9) 是一种钙锌结合蛋白，主要由中性粒细胞或巨噬细胞分泌，已被认为与 COVID-19 的严重程度和预后相关。通过分析相关研究，对 COVID-19 患者进行研究。Methods 对 PubMed、Web of Science 和 Cochrane Library 进行了全面检索，从建站到 2023 年 8 月 1 日，检索有关钙卫蛋白在 COVID-19 中应用的研究。使用 Stata 16.0 软件提取并汇总了有用的数据，例如不同组中的钙卫蛋白水平以及该生物标志物对重症 COVID-19 的诊断功效。 结果 本荟萃分析纳入了 15 项研究。首先，使用汇总标准化平均差 (SMD) 来估计重症和非重症 COVID-19 患者之间循环钙卫蛋白水平的差异。结果显示总体估计值为 1.84（95% 置信区间 [CI]：1.09–2.60）。从 11 项研究中提取诊断信息，钙卫蛋白诊断重症 COVID-19 的汇总敏感性和特异性分别为 0.75 (95% CI: 0.64–0.84) 和 0.88 (95% CI: 0.79–0.94)。AUC 为 0.89，合并 DOR 为 18.44（95% CI：9.07-37.51）。此外，在 COVID-19 患者中，循环钙卫蛋白水平升高与死亡结果风险较高之间存在很强的相关性（比值比：8.60，95% CI：2.17-34.12；p< 0.1)。结论这项荟萃分析表明，重症 COVID-19 患者中钙卫蛋白升高，这种非典型炎症细胞因子可能作为区分 COVID-19 严重程度和预测预后的有用生物标志物。