Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Galiero, Raffaele; Simeon, Vittorio; Loffredo, Giuseppe; Caturano, Alfredo; Rinaldi, Luca; Vetrano, Erica; Medicamento, Giulia; Alfano, Maria Rosaria; Beccia, Domenico; Brin, Chiara; Colantuoni, Sara; Salvo, Jessica Di; Epifani, Raffaella; Nevola, Riccardo; Marfella, Raffaele; Sardu, Celestino; Coppola, Carmine; Scarano, Ferdinando; Maggi, Paolo; Calabrese, Cecilia; Sposito, Pellegrino De Lucia; Rescigno, Carolina; Sbreglia, Costanza; Fraganza, Fiorentino; Parrella, Roberto; Romano, Annamaria; Calabria, Giosuele; Polverino, Benedetto; Pagano, Antonio; Numis, Fabio Giuliano; Bologna, Carolina; Nunziata, Mariagrazia; Esposito, Vincenzo; Coppola, Nicola; Maturo, Nicola; Nasti, Rodolfo; Micco, Pierpaolo Di; Perrella, Alessandro; Lettieri, Miriam; Adinolfi, Luigi Elio; Chiodini, Paolo; Sasso, Ferdinando Carlo

doi:10.3390/jcm11206121

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…Similarly, to what was recently reported for kidney failure[ 32 ], COVID-19-related mortality risk was strongly associated with the stage of liver impairment. Overall, the 30-d mortality risk is significantly increased in patients with decompensated liver cirrhosis hospitalized for COVID-19[ 15 , 30 ].…”

Section: Liver Cirrhosis and Covid-19 Clinical Outcomessupporting

confidence: 82%

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Nevola¹,

Criscuolo²,

Beccia³

et al. 2023

World J Gastroenterol

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Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it has represented a dramatic global public health concern. Though affecting mainly the respiratory system, SARS-CoV-2 disease, defined as coronavirus disease 2019 (COVID-19), may have a systemic involvement leading to multiple organ dysfunction. Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2. On the other side, patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19. In particular, patients with liver cirrhosis appear extremely vulnerable to infection. Moreover, the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes. This review analyzes the impact of the disease stage and the related causes on morbidity and mortality, clinical outcomes during SARS-CoV-2 infection, as well as the efficacy of vaccination in patients with chronic liver disease.

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Section: Liver Cirrhosis and Covid-19 Clinical Outcomessupporting

confidence: 82%

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Nevola¹,

Criscuolo²,

Beccia³

et al. 2023

World J Gastroenterol

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“…Recent investigations have revealed that individuals with DKD are more at risk of dying after catching COVID-19 ( 5 ). According to the prospective multicenter Italian COVOCA study, DM and CKD were closely related to intensive care admission and poor prognosis in patients hospitalized for COVID-19 ( 6 ). Thus, to avoid the progression of DKD, early intervention is required.…”

Section: Introductionmentioning

confidence: 99%

Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011-2018

et al. 2022

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ObjectiveDiabetic kidney disease (DKD) is the most common chronic kidney disease (CKD) and has the highest prevalence of end-stage kidney disease (ESKD) globally, owing mostly to the rise in Type 2 diabetes mellitus (T2DM) correlated with obesity. Current research suggested that the immune response and inflammation may play a role in the pathophysiology of T2DM. The systemic immune-inflammation index (SII) is a novel and integrated inflammatory biomarker that has not yet been linked to DKD. We aimed to identify the potential relationship between SII and DKD.MethodsIn the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018, the current cross-sectional study was conducted among adults with T2DM. SII was calculated as the platelet count × neutrophil count/lymphocyte count. DKD was diagnosed with impaired glomerular filtration rate (< 60 mL/min/1.73 m2 assessed by using the Chronic Kidney Disease Epidemiology Collaboration algorithm), albuminuria (urine albumin to creatinine ratio ≥ 30 mg/g), or both in T2DM patients. To investigate the independent association between SII and DKD, weighted univariate and multivariable logistic regression analyses and subgroup analyses were performed.ResultsThe study involved 3937 patients in total, of whom 1510 (38.4%) had DKD for the diagnosis. After adjustment for covariates, multivariable logistic regression revealed that a high SII level was associated with increased likelihood of DKD (OR = 1.42, 95% CI: 1.10-1.83, P = 0.01). Subgroup analyses and interaction tests revealed that age, gender, estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (ACR), body mass index (BMI), hypertension, hyperlipidemia, anti-inflammation therapy (yes or no), metformin use (yes or no), and insulin use (yes or no) had no significant dependence on this positive relationship (all p for interaction >0.05).ConclusionsOur results indicate that the higher SII level is associated with DKD in T2DM patients. The SII could be a cost-effective and straightforward approach to detecting DKD. This needs to be verified in further prospective investigations.

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“…Clinical variables + FIB-4 Values; 2. Clinical variables + FIB-4 groups [ 23 ]; 3. Clinical variables + Platelets; 4.…”

Section: Resultsmentioning

confidence: 99%

“…Clinical variables + Platelets +AST+ALT; 2) all these models were than compared with the concordance index (C-index) and the multivariable model with the highest score was preferred. The multivariable Cox’s regression models presented general results similar to the previous work, but some of them showed a significant association between mortality risk and FIB-4 Values (Model 1: HR 1.25, 95%CI 1.11–1.41; p<0.001), and the mortality risk is strongly associated with FIB-4 group of advanced fibrosis (Model 2: group 3 vs group 1 -ref-, HR 2.12, 95%CI 1.38–3.28, p<0.001) [ 23 ]. Instead, the other models did not show a significant association between mortality risk and FIB-4 exposure variables ( S1 File ).…”

Section: Resultsmentioning

confidence: 99%

“…Kendall’s τ_b coefficient was interpreted as follows: very weak if lower than ±10, weak if from ±10 to ±19, moderate if from ±20 to ±29, and strong if higher than ±30. Multivariable Cox’s regression models were employed to evaluate the associations between outcomes and clinical variables previously considered in another study [ 23 ]. Hazard ratios (HR) and their corresponding 95% confidence intervals (CI) were calculated for all models.…”

Section: Methodsmentioning

confidence: 99%

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Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy

Galiero,

Loffredo,

Simeon

et al. 2024

PLoS ONE

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Background & aims SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects. Methods This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.45<FIB-4<3.25; FIB-4>3.25), respectively group 1,2,3. Results At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox’s regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38–3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.45<FIB-4<3.25 (24.1%, group 2) and 69 a FIB-4>3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.45<FIB-4<3.25 (34.4%, group 2) and 76 a FIB-4>3.25 (42.3%, group 3). Conclusions FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage.

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Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Cited by 9 publications

References 38 publications

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011-2018

Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy

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