Evaluation of Urine L-FABP Point of Care Kit in the Philippines as Predictive Marker of Clinical Severity of COVID-19 (EPOCH COVID study)
Phillippine Journal of Internal Medicine
; 60(4):238-242, 2022.
Article
in English
| EMBASE | ID: covidwho-2293479
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. Method(s) 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 performedResults:
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%. Conclusion(s) 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.Copyright © The PHILIPPINE JOURNAL OF INTERNAL MEDICINE is a peer reviewed journal and a copyrighted publication of the Philippine College of Physicians.
covid-19; SIRS Criteria; Urine L-FABP POC (Point-of-Care) test; adult; aged; article; artificial ventilation; blood pressure; blood sampling; breathing rate; coronavirus disease 2019; disease severity; estimated glomerular filtration rate; female; health care facility; human; leukocyte count; lymphocyte count; major clinical study; male; multicenter study; oxygen saturation; patient triage; Philippines; platelet count; point of care testing; predictive value; proteinuria; pyuria; screening test; sensitivity and specificity; thorax radiography; urinalysis; validation study; very elderly; creatinine/ec [Endogenous Compound]; fatty acid binding protein/ec [Endogenous Compound]; hemoglobin/ec [Endogenous Compound]; point of care system
Search on Google
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Phillippine Journal of Internal Medicine
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS