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. 2022 Dec 13;11(12):1526.
doi: 10.3390/pathogens11121526.

Intestinal Fatty Acid Binding Protein (I-FABP) as a Prognostic Marker in Critically Ill COVID-19 Patients

Maciej Tyszko  1 , Małgorzata Lipińska-Gediga  1 , Anna Lemańska-Perek  2 , Katarzyna Kobylińska  3 , Waldemar Gozdzik  1 , Barbara Adamik  1
Affiliations

Intestinal Fatty Acid Binding Protein (I-FABP) as a Prognostic Marker in Critically Ill COVID-19 Patients

Maciej Tyszko et al. Pathogens. .

Abstract

Gastrointestinal symptoms are common in critically ill COVID-19 patients. There is currently no generally recognized method of assessing gastrointestinal injury in unconscious or sedated intensive care unit (ICU) patients. I-FABP (intestinal fatty acid binding protein) and citrulline have previously been studied as potential biomarkers of enterocyte damage in various gastrointestinal tract diseases, and changes in the levels of these markers may reflect intestinal wall damage in COVID-19. Patients with critical COVID-19, with diagnosed sepsis, or septic shock requiring ICU treatment were included in the study. Blood samples for citrulline and I-FABP were taken daily from day 1 to 5. I-FABP levels were significantly higher in patients who eventually died from COVID-19 than in survivors, and the optimal I-FABP cut-off point for predicting 28-day mortality was 668.57 pg/mL (sensitivity 0.739, specificity 0.765). Plasma levels of I-FABP, but not citrulline, were associated with significantly higher mortality and appeared to be a predictor of poor outcome in multivariate logistic regression analysis. In conclusion, I-FABP seems to be an effective prognostic marker in critically ill COVID-19 patients. Assessing mortality risk based on intestinal markers may be helpful in making clinical decisions regarding the management of intestinal injury, imaging diagnostics, and potential surgical interventions.

Keywords: COVID-19; I-FABP; biomarker; citrulline; intensive care; intestinal injury; sepsis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphs comparing the levels of I-FABP (intestinal fatty acid binding protein) (left panel) and citrulline (right panel) in the blood of Nonsurvivors and Survivors. The differences in the levels of biomarkers between study groups on corresponding days were marked with a p-value.
Figure 2
Figure 2
Kaplan–Meier curve showing 28-day survival stratified for patients with a baseline level of I-FABP ≤ 668.57 pg/mL (blue line) and >668.57 pg/mL (red line).
Figure 3
Figure 3
Graphs comparing the levels of I-FABP (left panel) and citrulline (right panel) in the blood of patients with and without septic shock. The differences in the levels of biomarkers between study groups on corresponding days were marked with a p-value.
See this image and copyright information in PMC

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