I-FABP is decreased in COVID-19 patients, independently of the prognosis

Abstract

Background: Severe acute respiratory syndrome caused by the novel coronavirus (SARS-CoV-2) is frequently associated with gastrointestinal manifestations. Herein we evaluated the interest in measuring the intestinal fatty acid-binding protein (I-FABP), a biomarker of intestinal injury, in COVID-19 patients.

Methods: Serum I-FABP was analyzed in 28 consecutive patients hospitalized for a PCR-confirmed COVID-19, in 24 hospitalized patients with non-COVID-19 pulmonary diseases, and 79 patients admitted to the emergency room for abdominal pain.

Results: I-FABP serum concentrations were significantly lower in patients with COVID-19, as compared to patients with non-COVID-19 pulmonary diseases [70.3 pg/mL (47-167.9) vs. 161.1 pg/mL (88.98-305.2), respectively, p = 0.008]. I-FABP concentrations in these two populations were significantly lower than in patients with abdominal pain without COVID-19 [344.8 pg/mL (268.9-579.6)]. I-FABP was neither associated with severity nor the duration of symptoms. I-FABP was correlated with polymorphonuclear cell counts.

Conclusions: In this pilot study, we observed a low I-FABP concentration in COVID-19 patients either with or without gastrointestinal symptoms, of which the pathophysiological mechanisms and clinical impact remain to be established. Further explorations on a larger cohort of patients will be needed to unravel the molecular mechanism of such observation, including the effects of malabsorption and/or abnormal lipid metabolism.

Fig 1. Serum I-FABP concentration is decreased in COVID-19 patients.

I-FABP concentrations were measured in COVID-19 patients (n = 28) and in patients with abdominal pain or pulmonary disease (n = 79 and 24, respectively). ANOVA and Mann-Whitney tests were used for statistical comparison. CRTL: control.

Fig 2. Serum I-FABP concentration is not associated with severe forms of COVID-19.

I-FABP concentrations were measured in COVID-19 patients from medical ward (n = 22) and ICU (n = 6) (left panel) and patients that live (n = 24) or deceased (n = 4; right pannel). Mann-Whitney test was used for statistical comparison.

Fig 3. Serum I-FABP correlated with the number of polymorphonuclear cells in COVID-19 patients.

Correlation table between serum concentration of I-FABP, citrulline, C reactive protein (CRP), and the number of leukocytes. Pearson correlation test was used. The correlation index is indicated. A negative sign indicates a negative correlation.