Faecal calprotectin indicates intestinal inflammation in COVID-19

GI symptoms such as diarrhoea, nausea and vomiting are frequent coronavirus disease (COVID-19) symptoms and affect up to 28% of patients.1–5 The pathophysiology of COVID-19-associated GI symptoms is currently unclear. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-RNA was detected in the faeces in ~50% of patients with COVID-193 5 6; SARS-CoV-2 viral particles were observed by electron microscopy in stool samples from two patients without diarrhoea2; and one study reported SARS-CoV-2 infection of the oesophagus, stomach, duodenum and rectum.5 Faecal calprotectin (FC) has evolved as a reliable faecal biomarker allowing detection of intestinal inflammation in IBD and infectious colitis.7 In this pilot study, we explored a relation between GI symptoms, intestinal inflammation (determined by FC) and faecal SARS-CoV-2-RNA in hospitalised patients with COVID-19 who did not require intensive care measures. We analysed 40 patients with COVID-19 hospitalised at the University Hospital of Innsbruck, Austria. Confirmation of SARS-CoV-2 infection was performed by nasopharyngeal swab, and faecal SARS-CoV-2-RNA detection was performed using previously described real-time PCR6 as recommended by the Centers for Disease Control and Prevention (DeKalb, Georgia). Diarrhoea was defined as loose stools u003e3 times/day. We excluded other causes of acute GI infection by stool analysis for common viral, …