Evaluation of urine L-FABP Point of care kit in the Philippines as predictive marker of clinical severity of COVID-19 (EPOCH COVID study)

Alberto Chua; Lynn Gomez; Rontgene Solante; Kay Beltran; Eric Chua; Renz Pasilan; Erika Chan; Nica Lee; Ann Celestyn Uichanco; Micaela San Diego; Abegail Danasen

Return

Evaluation of urine L-FABP Point of care kit in the Philippines as predictive marker of clinical severity of COVID-19 (EPOCH COVID study)

Author: Alberto Chua ¹ ; Lynn Gomez ² ; Rontgene Solante ³ ; Kay Beltran ¹ ; Eric Chua ⁴ ; Renz Pasilan ² ; Erika Chan ¹ ; Nica Lee ⁴ ; Ann Celestyn Uichanco ³ ; Micaela San Diego ⁴ ; Abegail Danasen ⁴
Author Information

1. University of the East Ramon Magsaysay Memorial Medical Center
2. University of the Philippines, Philippine General Hospital
3. San Lazaro Hospita
4. Chinese General Hospital and Medical Center
Publication Type:Journal Article
Keywords: Urine L-FABP POC (Point-of-Care) test; SIRS Criteria
MeSH: COVID-19
From: Philippine Journal of Internal Medicine 2022;60(4):238-242
CountryPhilippines
Language:English
Abstract: Background:The search for simple clinical and laboratory markers to help predict the clinical severity of patients presenting with COVID-19 has prompted this study to look at the predictive value of urine L-FABP (Liver Type-Fatty Acid Binding Protein) point-of-care test kit at the initial presentation of COVID-19 patients to the hospital.
Methods:The validation study prospectively included 109 consecutive patients with mild to moderate COVID-19, mean age of 52.2 years (range 19-84) presenting at the Emergency Rooms of 4 participating Metro-Manila hospitals from February to April 2021, with available data for analysis for 103 patients. Urine L-FABP POC (Point-of-Care) test and other clinical parameters and the level of severity of COVID-19 were determined at Day 0, Day 4 and Day 7. Computations for Sensitivity, Specificity, Positive and Negative Predictive values and Likelihood ratios were performed.
Results:Twenty-three patients tested positive for urine L-FABP, out of the 103 patients analyzed, while 80 tested negative. Of the 23 patients who tested positive for urine L-FABP, 6 has progressed in severity, while 17 did not progressed. Of the 80 patients who tested negative for urine L-FABP, 13 progressed, while 67 did not progressed in severity. Giving a Sensitivity of 31.58%, Specificity of 79.76%, Positive predictive value of 26.09%, Negative predictive value of 83.75%. Combining urine L-FABP and initial clinical parameters like SIRS (Systemic Inflammatory Response Syndrome) criteria to predict progression of severity yielded a higher Specificity of 91.67 % and Negative Predictive value of 84.62%.
Conclusions:The study shows the utility of initial urine L-FABP POC test as a negative screening test in triaging adult patients presenting to the ER with mild to moderate COVID-19. Patients at the ER with a negative urine L-FABP test, will most likely not progressed to severe COVID-19. Combining clinical parameters like SIRS Criteria with the urine L-FABP result can increase the negative predictive value.
Full text:1 - Evaluation.pdf