Terakawa Kanako, Katagiri Daisuke, Asai Yusuke, Ishikane Masahiro, Ohmagari Norio, Suzuki Minami, Hojo Masayuki, Takano Hideki, Tokunaga Katsushi, Sugaya Takeshi, Noiri Eisei
Department of Nephrology, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan.
Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
PLoS One. 2025 Sep 11;20(9):e0331558. doi: 10.1371/journal.pone.0331558. eCollection 2025.
Although the symptoms of Coronavirus Disease 2019 (COVID-19) omicron strains are generally mild, some individuals with initially mild symptoms later required supplemental oxygen or hospitalization, while others died, highlighting the importance of rapid diagnosis and early treatment for such patients. Therefore, this study evaluated the benefit of a combined approach to identify individuals at risk of severe illness due to COVID-19 using urinary L-type fatty acid-binding protein (L-FABP) levels and the Sequential Organ Failure Assessment (SOFA) scores calculated from blood tests for pre-admission screening of patients with COVID-19. L-FABP, a non-invasive urine biomarker, and the SOFA score, an established method for assessing organ failure severity, were evaluated in conjunction with patient data collected from 842 individuals admitted to a hospital in Tokyo, Japan. The combined approach demonstrated a higher accuracy in identifying patients at risk of severe illness compared to the L-FABP levels or SOFA scores alone. Thus, the results suggest that a two-tiered screening process, utilizing measurement of L-FABP levels as an initial rapid test, followed by SOFA score assessment for high-risk patients, results in efficient pre-admission screening and improved patient management. In conclusion, this study underscores the potential of combining L-FABP levels and SOFA scores for optimizing patient care during the ongoing COVID-19 pandemic, emphasizing the need for further validation and refinement of the predictive models.
尽管2019冠状病毒病(COVID-19)奥密克戎毒株的症状通常较轻,但一些最初症状较轻的患者后来需要补充氧气或住院治疗,还有一些患者死亡,这凸显了对此类患者进行快速诊断和早期治疗的重要性。因此,本研究评估了一种联合方法的益处,该方法通过尿L型脂肪酸结合蛋白(L-FABP)水平和根据血液检测计算的序贯器官衰竭评估(SOFA)评分来识别因COVID-19而有重症风险的个体,用于COVID-19患者入院前筛查。L-FABP是一种非侵入性尿液生物标志物,SOFA评分是评估器官衰竭严重程度的既定方法,结合从日本东京一家医院收治的842名患者收集的患者数据对其进行了评估。与单独使用L-FABP水平或SOFA评分相比,联合方法在识别有重症风险的患者方面具有更高的准确性。因此,结果表明,采用两层筛查流程,首先将L-FABP水平测量作为初始快速检测,然后对高危患者进行SOFA评分评估,可实现高效的入院前筛查并改善患者管理。总之,本研究强调了在当前COVID-19大流行期间,结合L-FABP水平和SOFA评分以优化患者护理的潜力,强调需要对预测模型进行进一步验证和完善。