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Gastroenterology Review/Przegląd Gastroenterologiczny
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Artykuł oryginalny

Faecal calprotectin in COVID-19 patients with intestinal symptoms

Walid Ismail Ellakany
1
,
Ahmed Mohamed AbdelHady
2
,
Mohamed Wael Nassar
3
,
Reham Abdel Haleem Abo Elwafa
4

1.
Tropical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2.
Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
3.
Anaesthesia and Surgical Intensive Care Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
4.
Clinical and Chemical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Gastroenterology Rev
Data publikacji online: 2022/03/18
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Introduction
Extra-pulmonary manifestations of the Coronavirus disease of 2019 (COVID-19) have been increasingly reported, especially gastrointestinal and hepatic system dysfunction. The concern of faecal-oral transmission for COVID-19 was raised.

Aim
To study the trend of faecal calprotectin in COVID-19 patients with intestinal symptoms.

Material and methods
Forty confirmed cases of COVID-19 infection presenting with diarrhoea were subjected to a thorough history taking, clinical examination, and routine laboratory investigations. They were treated according to the Egyptian MOH guidelines. Faecal calprotectin (FC) concentration was measured at initial presentation and after 3 months. Those who had persistently elevated levels ≥ 200 µg/g were subjected to colonoscopic examination and histopathological examination. Forty confirmed cases of COVID-19 without diarrhoea were recruited as a control group in the initial FC evaluation.

Results
Faecal calprotectin was found to be significantly elevated in the studied COVID-19 patients who presented with diarrhoea, with a mean value 260 ±80 µg/g compared to the those without diarrhoea, with a mean value of 31.6 ±12.9 µg/g (p < 0.001). Moreover, 20% (8 patients) had an elevated level exceeding 200 µg/g 3 months after recovery; among them, 5 patients showed mild colonoscopic changes whereas 3 patients showed severe ileocolitis. Out of the 3 patients with marked ileocolitis, 2 showed histopathological changes raising the diagnosis of Crohn’s disease.

Conclusions
Faecal calprotectin was found to be elevated in COVID-19 patients with intestinal symptoms, especially diarrhoea, with or without colonoscopic and histopathological changes.

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