High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study

Kim, Sung Woo; Jeon, Jae‐Han; Moon, Jun Sung; Kim, Mi Kyung

doi:10.3803/enm.2021.1040

Cited by 8 publications

(9 citation statements)

References 33 publications

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“…COVID-19 damages not only the lungs but also the liver and other solid organs (20,21). The impact of liver injury on the prognosis of COVID-19 24). For example, in patients with hepatitis C and SARS-CoV-2 infection, the FIB-4 score was associated with hospitalization but not mortality (6.6% vs. 6.5%; p=0.9) (22).…”

Section: Discussionmentioning

confidence: 99%

“…The impact of liver injury on the prognosis of COVID-19 can be severe, as can that of pneumonia. Although COVID-19 is reported to have more severe consequences in patients with chronic liver disease and a high FIB-4 score, large-scale studies on this topic are needed ( 22 - 24 ). For example, in patients with hepatitis C and SARS-CoV-2 infection, the FIB-4 score was associated with hospitalization but not mortality (6.6% vs. 6.5%; p =0.9) ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…APRI, another score that can be used to determine liver fibrosis, has also been associated with the severity and prognosis of COVID-19. APRI has been frequently compared with FIB-4 in many studies ( 10 , 18 , 19 , 24 , 25 ). In a study involving 202 hospitalized patients with COVID-19, further analysis that also accounted for gender and liver disease found that each unit increase in FIB-4 was an independent predictor of mortality (odds ratio [OR]=1.79, 95% CI=1.36-2.35; p <0.001).…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis of thirteen studies examining the association between FIB-4 and COVID-19 prognosis, a high FIB-4 score was found to increase mortality 3-fold (OR=3.01, 95% CI=2.21-4.09; p <0.001) ( 19 ). Woo-Kim et al observed 10-fold increased deaths in COVID-19 patients with a high FIB-4 score and diabetes mellitus than in patients with a low FIB-4 score without diabetes mellitus ( 24 ). As a result, different cut-off values for FIB-4 and APRI scores were used in mortality studies.…”

Section: Discussionmentioning

confidence: 99%

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The Role of APRI, FIB-4, and SAD-60 Scores as Predictors of Mortality in COVID-19 Patients

Copur¹,

Sürme²,

Tuncer³

et al. 2023

Infect Dis Clin Microbiol

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Objective: Predictors of mortality that indicate disease severity plays an important role in COVID-19 management and treatment decisions. This study aimed to investigate the association between fibrosis-4 (FIB-4) score, aspartate aminotransferase-to-platelet ratio index (APRI), and novel biomarker-based score (SAD-60) with mortality in COVID-19 patients treated in a tertiary hospital. Materials and Methods: In this single-center retrospective study, patients ≥18 years of age who were admitted to our hospital for COVID-19 between December 1 and 31, 2021, were included. Patients were divided into two groups as deceased and survived. A comparative analysis was applied. Predictive abilities of the FIB-4, APRI, and SAD-60 scores for in-hospital mortality were evaluated. Results: Of the 453 patients enrolled in the study, 248 (54.6%) were male, and the mean age was 52.2±14.7 years. Mortality was recorded in 39 (8.5%) of the patients. The median values of APRI (0.43 and 0.58; p=0.001), FIB-4 score (1.66 and 2.91; p<0.001), and SAD-60 (2 and 8.25; p<0.001) were higher in deceased patients than in survivors. The optimal cut-off value for predicting mortality in the receiver operating characteristic (ROC) curve analysis was 0.58 for APRI (sensitivity=56.4%, specificity=63.6%); 2.14 for FIB-4 score (sensitivity=79.5%, specificity=68.2%); 4.25 for SAD-60 (sensitivity=90%, specificity=73.8%). In Cox regression analysis with a model that included gender, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD), FIB-4 (hazard ratio [HR]=4.013, 95% confidence interval [CI]=1.643-9.803; p=0.002), and SAD-60 (HR=8.850, 95% CI=1.035-75.696; p=0.046) were independent risk factors for mortality. Conclusion: SAD-60 and FIB-4 scores are easily applicable and may be used to predict mortality in COVID-19 patients. Keywords: APRI, FIB-4, SAD-160, COVID-19, mortality, predictors

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Role of APRI, FIB-4, and SAD-60 Scores as Predictors of Mortality in COVID-19 Patients

Copur¹,

Sürme²,

Tuncer³

et al. 2023

Infect Dis Clin Microbiol

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“…Recently, several laboratory indices of liver fibrosis have been reported to be useful predictors of liver fibrosis ( 9 , 10 ). An elevated fibrosis-4 (FIB-4) index was associated with higher risks of worse outcomes for liver diseases ( 11 ). Similar predictive values for adverse liver events were seen in the aspartate aminotransferase/platelet ratio index (APRI) and the Forns index ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Prognostic Significance of Liver Fibrosis in Patients With Aneurysmal Subarachnoid Hemorrhage

Wang

Gong

et al. 2022

Front. Neurol.

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ObjectivesTo report the prevalence, clinical associations, and prognostic consequences of liver fibrosis in patients with aneurysmal subarachnoid hemorrhage (aSAH).MethodsIn a retrospective study of patients with aSAH, we evaluated three validated liver fibrosis indices and modeled them as continuous-exposure variables, including the aspartate aminotransferase/platelet ratio index (APRI), the fibrosis-4 (FIB-4) index, and the Forns index. The primary outcome was mortality at 90 days. We compared the addition of fibrosis indices to the predictors of the full Subarachnoid Hemorrhage International Trialists model.ResultsA total of 3,722 patients with aSAH were included in the study. According to the APRI, FIB-4 index, and Forns index, 21.7, 17.7, and 11.4% of patients had liver fibrosis. After adjusting for potential confounding factors, liver fibrosis indices were associated with increased 90-day mortality, with odds ratios of 1.35 (95% CI 1.02–1.77) for the FIB-4 index, 1.39 (95% CI.08–1.78) for APRI, and 1.53 (95% CI 1.11–2.12) for the Forns index. Similarly, high liver fibrosis indices were associated with an increased risk of rebleeding. However, the Forns index was not significantly associated with mortality and rebleeding. The addition of FIB-4 indices and APRI into the standard model improved the mortality prediction.ConclusionsLiver fibrosis is common in patients with aSAH, and high liver fibrosis indices are associated with mortality and rebleeding. The addition of liver fibrosis indices to a standard clinical model significantly improves risk stratification.

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Differential Effects of COVID-19 Hospitalization on the Trajectory of Liver Disease Progression

Hatipoglu¹,

Mulligan²,

Wang³

et al. 2023

Gastro Hep Advances

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High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study

Cited by 8 publications

References 33 publications

The Role of APRI, FIB-4, and SAD-60 Scores as Predictors of Mortality in COVID-19 Patients

The Role of APRI, FIB-4, and SAD-60 Scores as Predictors of Mortality in COVID-19 Patients

Prevalence and Prognostic Significance of Liver Fibrosis in Patients With Aneurysmal Subarachnoid Hemorrhage

Differential Effects of COVID-19 Hospitalization on the Trajectory of Liver Disease Progression

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