{"doi":"10.1101/2020.05.06.20093070","title":"Neutrophil calprotectin identifies severe pulmonary disease in COVID-19","abstract":"Severe cases of coronavirus disease 2019 (COVID-19) are regularly complicated by respiratory failure. While it has been suggested that elevated levels of blood neutrophils associate with worsening oxygenation in COVID-19, it is unknown whether neutrophils are drivers of the thrombo-inflammatory storm or simple bystanders. To better understand the potential role of neutrophils in COVID-19, we measured levels of the neutrophil activation marker S100A8/A9 (calprotectin) in hospitalized patients and determined its relationship to severity of illness and respiratory status. Patients with COVID-19 (n=172) had markedly elevated levels of calprotectin in their blood. Calprotectin tracked with other acute phase reactants including C-reactive protein, ferritin, lactate dehydrogenase, and absolute neutrophil count, but was superior in identifying patients requiring mechanical ventilation. In longitudinal samples, calprotectin rose as oxygenation worsened. When tested on day 1 or 2 of hospitalization (n=94 patients), calprotectin levels were significantly higher in patients who progressed to severe COVID-19 requiring mechanical ventilation (8039 +/- 7031 ng/ml, n=32) as compared to those who remained free of intubation (3365 +/- 3146, p<0.0001). In summary, serum calprotectin levels track closely with current and future COVID-19 severity, implicating neutrophils as potential perpetuators of inflammation and respiratory compromise in COVID-19.","journal":"medRxiv","year":2020,"id":118910,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":35,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9574,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":259811,"name":"Yu Zuo","orcid":"0000-0001-6721-7755","position":1,"is_corresponding":false},{"id":105691,"name":"Srilakshmi Yalavarthi","orcid":"0009-0005-9128-572X","position":2,"is_corresponding":false},{"id":105693,"name":"Kelsey Gockman","orcid":null,"position":3,"is_corresponding":false},{"id":105694,"name":"Melanie Zuo","orcid":null,"position":4,"is_corresponding":false},{"id":105695,"name":"Jacqueline A. Madison","orcid":"0000-0003-1745-8133","position":5,"is_corresponding":false},{"id":105696,"name":"Christopher Blair","orcid":"0000-0002-4782-6788","position":6,"is_corresponding":false},{"id":261393,"name":"Wrenn Woodward","orcid":null,"position":7,"is_corresponding":false},{"id":109636,"name":"Sean P. Lezak","orcid":null,"position":8,"is_corresponding":false},{"id":109637,"name":"Njira Lugogo","orcid":"0000-0002-0235-7105","position":9,"is_corresponding":false},{"id":105699,"name":"Robert J. Woods","orcid":"0000-0002-0679-9998","position":10,"is_corresponding":false},{"id":469037,"name":"Christian Lood","orcid":"0000-0002-6171-1952","position":11,"is_corresponding":false},{"id":105701,"name":"Jason S. Knight","orcid":"0000-0003-0995-9771","position":12,"is_corresponding":false},{"id":105700,"name":"Yogendra Kanthi","orcid":"0000-0002-5660-5194","position":13,"is_corresponding":false},{"id":109631,"name":"Hui Shi","orcid":"0000-0002-3574-8807","position":0,"is_corresponding":true}],"reference_count":69,"raw_metadata":null,"created_at":"2026-07-18T23:14:03.409507Z","pmid":"32511540","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}