{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T13:18:29Z","timestamp":1772889509329,"version":"3.50.1"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["20he0822003j0001"],"award-info":[{"award-number":["20he0822003j0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["23K07687"],"award-info":[{"award-number":["23K07687"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["20A2013"],"award-info":[{"award-number":["20A2013"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012319","name":"National Center for Global Health and Medicine","doi-asserted-by":"publisher","award":["21A2002"],"award-info":[{"award-number":["21A2002"]}],"id":[{"id":"10.13039\/100012319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1371\/journal.pone.0331558","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:24:46Z","timestamp":1757611486000},"page":"e0331558","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective cohort study evaluating the predictive value of urinary L-FABP combined with the SOFA score for assessing COVID-19 severity"],"prefix":"10.1371","volume":"20","author":[{"given":"Kanako","family":"Terakawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-2644","authenticated-orcid":true,"given":"Daisuke","family":"Katagiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Asai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Ishikane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Ohmagari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minami","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9595-9657","authenticated-orcid":true,"given":"Masayuki","family":"Hojo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Takano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5501-0503","authenticated-orcid":true,"given":"Katsushi","family":"Tokunaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Sugaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisei","family":"Noiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"issue":"8","key":"pone.0331558.ref001","article-title":"Evaluation of Coronavirus Disease 2019 Severity Using Urine Biomarkers","volume":"2","author":"D Katagiri","year":"2020","journal-title":"Crit Care Explor"},{"issue":"3","key":"pone.0331558.ref002","article-title":"Urinary L-Type Fatty Acid-Binding Protein Predicts Oxygen Demand of COVID-19 in Initially Mild Cases","volume":"5","author":"D Katagiri","year":"2023","journal-title":"Crit Care Explor"},{"issue":"32","key":"pone.0331558.ref003","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000026900","article-title":"The prognostic value of the SOFA score in patients with COVID-19: A retrospective, observational study","volume":"100","author":"Z Yang","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"pone.0331558.ref004","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","author":"F Zhou","year":"2020","journal-title":"Lancet"},{"key":"pone.0331558.ref005","article-title":"A trial of lopinavir-ritonavir in adults hospitalized with severe covid-19","author":"B Cao","year":"2020","journal-title":"N Engl J Med"},{"issue":"7","key":"pone.0331558.ref006","doi-asserted-by":"crossref","first-page":"2242","DOI":"10.1093\/ndt\/gfm949","article-title":"Diagnostic accuracy of the protein\/creatinine ratio in urine samples to estimate 24-h proteinuria in patients with primary glomerulopathies: a longitudinal study","volume":"23","author":"VVH Antunes","year":"2008","journal-title":"Nephrol Dial Transplant"},{"issue":"10","key":"pone.0331558.ref007","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1038\/ki.2012.266","article-title":"Mild elevation of urinary biomarkers in prerenal acute kidney injury","volume":"82","author":"K Doi","year":"2012","journal-title":"Kidney Int"},{"issue":"1","key":"pone.0331558.ref008","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1186\/s13054-019-2663-7","article-title":"The SOFA score-development, utility and challenges of accurate assessment in clinical trials","volume":"23","author":"S Lambden","year":"2019","journal-title":"Crit Care"},{"issue":"2","key":"pone.0331558.ref009","doi-asserted-by":"crossref","first-page":"213","DOI":"10.31662\/jmaj.2023-0165","article-title":"Change in the Proportion of Death at Home during the COVID-19 Pandemic and Its Associated Factors in the Municipality Level: A Nationwide Study in Japan","volume":"7","author":"Y Sun","year":"2024","journal-title":"JMA J"},{"issue":"7","key":"pone.0331558.ref010","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1007\/s10157-023-02456-5","article-title":"Urine oxygenation predicts COVID-19 risk","volume":"28","author":"E Noiri","year":"2024","journal-title":"Clinical and Experimental Nephrology"},{"issue":"4","key":"pone.0331558.ref011","doi-asserted-by":"crossref","DOI":"10.1152\/ajprenal.90513.2008","article-title":"Urinary fatty acid-binding protein 1: an early predictive biomarker of kidney injury","volume":"296","author":"E Noiri","year":"2009","journal-title":"Am J Physiol Renal Physiol"},{"issue":"11","key":"pone.0331558.ref012","doi-asserted-by":"crossref","first-page":"2894","DOI":"10.1681\/ASN.2007010097","article-title":"Renal L-type fatty acid--binding protein in acute ischemic injury","volume":"18","author":"T Yamamoto","year":"2007","journal-title":"J Am Soc Nephrol"},{"key":"pone.0331558.ref013","article-title":"Interstitial renal fibrosis due to multiple cisplatin treatments is ameliorated by semicarbazide-sensitive amine oxidase inhibition","author":"D Katagiri","year":"2015","journal-title":"Kidney Int"},{"issue":"2","key":"pone.0331558.ref014","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.athoracsur.2011.10.048","article-title":"Combination of two urinary biomarkers predicts acute kidney injury after adult cardiac surgery","volume":"93","author":"D Katagiri","year":"2012","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"pone.0331558.ref015","first-page":"545","article-title":"Urinary L-type fatty acid-binding protein as a new renal biomarker in critical care","volume":"16","author":"K Doi","year":"2010","journal-title":"Curr Opin Crit Care"},{"issue":"11","key":"pone.0331558.ref016","doi-asserted-by":"crossref","first-page":"2464","DOI":"10.1097\/CCM.0b013e318225761a","article-title":"Evaluation of new acute kidney injury biomarkers in a mixed intensive care unit","volume":"39","author":"K Doi","year":"2011","journal-title":"Crit Care Med"},{"issue":"2","key":"pone.0331558.ref017","doi-asserted-by":"crossref","first-page":"482","DOI":"10.3390\/jcm9020482","article-title":"Urinary Liver-Type Fatty-Acid-Binding Protein Predicts Long-Term Adverse Outcomes in Medical Cardiac Intensive Care Units","volume":"9","author":"H Naruse","year":"2020","journal-title":"J Clin Med"},{"issue":"11","key":"pone.0331558.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0307938","article-title":"Clustering based on renal and inflammatory admission parameters in critically ill patients admitted to the ICU","volume":"19","author":"O Mascle","year":"2024","journal-title":"PLoS One"},{"issue":"7","key":"pone.0331558.ref019","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/BF01709751","article-title":"The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction\/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine","volume":"22","author":"JL Vincent","year":"1996","journal-title":"Intensive Care Med"},{"issue":"8","key":"pone.0331558.ref020","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"3","key":"pone.0331558.ref021","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1001\/jama.2016.20328","article-title":"Prognostic Accuracy of the SOFA Score, SIRS Criteria, and qSOFA Score for In-Hospital Mortality Among Adults With Suspected Infection Admitted to the Intensive Care Unit","volume":"317","author":"EP Raith","year":"2017","journal-title":"JAMA"},{"issue":"10","key":"pone.0331558.ref022","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1016\/j.ajem.2020.07.019","article-title":"Predictive performance of SOFA and qSOFA for in-hospital mortality in severe novel coronavirus disease","volume":"38","author":"S Liu","year":"2020","journal-title":"Am J Emerg Med"},{"key":"pone.0331558.ref023","volume-title":"WHO consolidated guidelines on tuberculosis: module 2: screening \u2013 systematic screening for tuberculosis disease","author":"World Health Organization","year":"2021"},{"issue":"12","key":"pone.0331558.ref024","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/S2213-2600(20)30404-5","article-title":"Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromes","volume":"8","author":"DE Leisman","year":"2020","journal-title":"Lancet Respir Med"},{"key":"pone.0331558.ref025","doi-asserted-by":"crossref","first-page":"118431","DOI":"10.1016\/j.lfs.2020.118431","article-title":"SARS-CoV-2 and coagulation disorders in different organs","volume":"260","author":"S Vinayagam","year":"2020","journal-title":"Life Sci"},{"key":"pone.0331558.ref026","article-title":"Incidence of thrombotic complications in critically ill ICU patients with COVID-19","author":"FA Klok","year":"2020","journal-title":"Thrombosis Research"},{"issue":"3","key":"pone.0331558.ref027","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/nep.14254","article-title":"Urinary liver-type fatty acid binding protein is a biomarker reflecting renal damage and the ameliorative effect of drugs at an early stage of histone-induced acute kidney injury","volume":"29","author":"K Ohata","year":"2024","journal-title":"Nephrology (Carlton)"},{"issue":"2","key":"pone.0331558.ref028","doi-asserted-by":"crossref","first-page":"94","DOI":"10.35772\/ghm.2022.01004","article-title":"For safe and adequate blood purification therapy in severe COVID-19 \u2012 what we have learned so far","volume":"4","author":"D Katagiri","year":"2022","journal-title":"Glob Health Med"},{"key":"pone.0331558.ref029","doi-asserted-by":"crossref","first-page":"1879554","DOI":"10.1155\/2023\/1879554","article-title":"COVID-19: an overview of SARS-CoV-2 Variants - The Current Vaccines and Drug Development","volume":"2023","author":"N Bostanghadiri","year":"2023","journal-title":"BioMed Research International"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:24:51Z","timestamp":1757611491000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331558"}},"subtitle":[],"editor":[{"given":"Vipa","family":"Thanachartwet","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,11]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0331558","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]}}}