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Abstract: PO0785

Can Urine Biomarkers Predict Severity of COVID-19? A Preliminary Study

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Katagiri, Daisuke, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Noiri, Eisei, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Ishikane, Masahiro, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Asai, Yusuke, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Kinoshita, Noriko, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Ohmagari, Norio, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
  • Hinoshita, Fumihiko, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
Background

Early detection of coronavirus disease (COVID-19) in patients likely to develop severe manifestations enables appropriate interventions, including rapid intensive care unit admission. This study was conducted to determine whether non-invasive urine biomarkers can predict the clinical severity of COVID-19.

Methods

Design
A retrospective case series.

Setting
Single-center study, national center hospital designated for infectious disease.

Patients
Fifty-eight patients who tested positive for SARS-CoV-2 in respiratory specimens through real-time reverse transcription-polymerase chain reaction (RT-PCR) were retrospectively studied.

Measurements and main results
Urinary β2-microglobulin (β2MG), liver-type fatty acid-binding protein (L-FABP) were serially measured. Serum interferon γ and monocyte chemotactic protein-1 were also evaluated.

Results

The 58 patients were assigned into three groups. Patients requiring intensive care were assigned to the severe group (N = 12). Patients treated with oxygen were assigned to the moderate group (N = 13). Other patients were assigned to the mild group (N = 33). Urine tests revealed that low β2MG and L-FABP levels on admission were associated with mild disease, whereas high levels were associated with severe disease. In severe cases, L-FABP tended to be persistently high. The resulting cutoff values were β2MG; Severe vs. Moderate+Mild: 2457 μg/dL (Specificity 76.9% and Sensitivity 90.0%, AUC 85.9%), L-FABP; Severe vs. Moderate+Mild: 22.0 μg/gCre (Specificity 84.6% and Sensitivity 90%, AUC 91.8%). Urinary β2MG and serum IFN-γ/MCP-1 showed a similar trend.

Conclusion

Evaluating urinary biomarkers such as β2MG and L-FABP may allow determination of COVID-19 patients with active cytokines and recognition of patients likely to become critically ill and requiring careful observation and early intervention.

Funding

  • Government Support - Non-U.S.