An increased Intestinal fatty-acid binding protein (I-FABP) level in urine indicates enterocyte cell damage. A prospective cohort study with 283 SARS-CoV-2 inpatients (survivors and non-survivors patients) and healthy volunteers was conducted to investigate the role of I-FABP as a predictor of disease severity and poor prognosis.. Venous blood and urine samples were collected at admission, and on 7th and 14th day of hospitalization. I-FABP and cytokines (TNF-α, IFN-γ and IL-6) were measured by ELISA. The results showed that non-survivors exhibited a higher rate of comorbidities such as cardiovascular and pulmonary diseases, diabetes, degenerative and malignancies and there were deviations in laboratory parameters. Also, mechanical ventilation and intensive care at admission were required. Furthermore, at 7th and 14th day of hospitalization, ageing, pre-existing diseases, leukocytosis and the need for mechanical ventilation were relevant among non-survivor patients. Additionally, COVID-19 patients showed approximately 48, 74 and 125 fold increase in urinary I-FABP levels at admission, 7th and 14th day of hospitalization, respectively. Critically ill and non-survivor patients showed higher I-FABP levels compared to infirmary and survivor patients. An increased plasma IFN-γ and IL-6 levels were observed in SARS-CoV-2 patients. Also, urinary IL-6 concentrations were elevated in infected and non-survivors. Patients with I-FABP ≥ 6.89 ng/mg showed higher plasma and urine IL-6 and serum CRP concentrations, which is a predictive cytokine of disease progression and ARDS complications.
Thus, it can be concluded that the loss of enterocyte membrane integrity correlated with increased I-FABP levels in SARS-CoV-2 patients. Thus, increased I-FABP levels at admission may predict poor prognosis and SARS-CoV-2 illness severity.
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Ref Link: Pubmed