Prevalence and Prognostic Importance of High Fibrosis-4 Index in COVID-19 Patients

Abstract

Introduction. The fibrosis 4 (FIB-4) index was developed to predict advanced fibrosis in patients with liver disease. We aimed to evaluate the association of FIB-4 with risk factors for progression to critical illness in middle-aged patients hospitalized for coronavirus disease 2019 (COVID-19). Method. We included patients aged 35–65 years who were hospitalized following a positive RT-PCR SARS-Cov-2 test in a tertiary hospital. All data were obtained from the medical records of the patients during the first admission to the hospital. The FIB-4 index was calculated according to the equation (age (years) x AST (IU/L)/platelet count (109/L)/√ALT (IU/L)). The FIB-4 index was divided into three categories according to the score categorisation: <1.3 = low risk, 1.3–2.67 = moderate risk, and >2.67 = high risk. Results. A total of 619 confirmed COVID-19 patients (mean age = 52 yrs.) were included in this study; 37 (6.0%) were admitted to the intensive care unit (ICU), of which 44% were intubated and eight (1.3%) patients died during follow-up. The results of patients with high FIB-4 scores were compared with those with low FIB-4 scores. In patients with high FIB-4 scores, male gender, and advanced age, decreased neutrophil, lymphocyte, thrombocyte, and albumin counts, elevated AST, LDH, CK, ferritin, CRP, and D-dimer, and low GFR were the high-risk factors for critical illness. Additionally, the number of patients referred to ICU with high FIB-4 who died had higher scores than from those with low scores. Conclusion. The FIB-4 index derived from baseline data obtained during hospitalisation can be used as a simple, inexpensive, and straightforward indicator to predict ICU requirement and/or death in middle-aged hospitalized COVID-19 patients.

Association of Non-Alcoholic Fatty Liver Disease and Metabolic-Associated Fatty Liver Disease with COVID-19-Related Intensive Care Unit Outcomes: A Systematic Review and Meta-Analysis

“…Of the total 5286 patients, 1623 had severe COVID-19, with 33.17% (901/2716) of MAFLD patients having severe COVID-19 disease, as opposed to 28.09% (722/2570) of the non-MAFLD patients. The odds ratio was 1.59 for disease patients with and without MAFLD sensitivity analysis after excluding Tignanelli et al [28][29][30]34,36,38,40,43,[45][46][47][48]52].…”

“… Forest plot for ICU admissions in COVID-19 patients with and without MAFLD sensitivity analysis after excluding Tignanelli et al, 2021 [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 38 , 40 , 41 , 43 , 45 , 47 , 50 , 52 ]. …”

“… Forest plot and meta-analysis of the need for invasive mechanical ventilation in COVID-19 patients with and without MAFLD [ 28 , 29 , 30 , 34 , 36 , 38 , 40 , 43 , 45 , 46 , 47 , 48 , 52 ]. …”

“…Figure 3. Forest plot for ICU admissions in COVID-19 patients with and without MAFLD sensitivity analysis after excluding Tignanelli et al, 2021[26][27][28][29][30][31][32]34,35,38,40,41,43,45,47,50,52].…”

“…Figure 11. Forest plot and meta-analysis of disease severity in COVID-19 patients with and without MAFLD sensitivity analysis after excluding Kim et al[26,30,33,[35][36][37]39,40,42,44,[49][50][51]53].…”