Fibrosis-4 Index as a Predictor for Disease Severity and Mortality in Patients with COVID-19

Abstract

Objective: The Fibrosis-4 (FIB-4) index is a noninvasive marker of liver fibrosis in various patient populations. We examined whether there is a relationship between the severity and prognosis of COVID-19 disease and the FIB-4 index. Materials and Methods: This stuy is a cross-sectional and retrospective. The patients were divided into two groups as those hospitalized in the intensive care unit (ICU) and those hospitalized in the clinic (non- ICU). Results: Of the total 158 cases,86(54%) were male. Age, total bilirubin, AST levels and FIB-4 index were higher in ICU patients compared to non-ICUs (p<0.001,p=0.002, p=0.003, p<0.001 respectively). FIB-4 index non-survivors were also higher (p=0.002). When the effect of the FIB-4 index on the severity of COVID-19 disease and mortality was evaluated by ROC analysis, both ICU and non-survivors were found to be significant (respectively FIB-4 score;AUC=0.705,95%CI:0.624-785,p<0.001;AUC=0.654,95%CI:0.566-742,p=0.002). When the FIB-4 index cut-off value for disease severity was taken as 2.19, 70.0% sensitivity and 60% specificity were found in predicting disease severity. Moreover, when the FIB-4 index cut-off value for mortality was taken as 2.19, 71.2% sensitivity and 53% specificity were found in predicting mortality. Conclusion: The FIB-4 index is an independent predictor of severity and mortality in COVID-19 patients requiring ICU.

Keywords

• COVID-19
• FIB-4 index,
• mortality

COVID-19 Hastalarında Hastalık Şiddeti ve Mortalite için Bir Öngörücü Olarak Fibrozis-4 Indeksi

Öz

Amaç: Fibrosis 4 (FIB-4) index çeşitli hasta popülasyonlarında karaciğer fibrozisini gösteren non invaziv bir belirteçdir. Çalışmamızda COVİD-19 hastalığının ciddiyeti ve mortalite ile FIB-4 skoru arasında ilişki olup olmadığını incelemeyi planladık. Gereç ve Yöntem: Bu çalışma kesitsel retrospektiftir. COVID-19 tanısı doğrulanmış olup hastanede yatan 158 hastayı içermektedir. Hastalar yoğun bakım ünitesinde (ICU) yatanlar ve kliniğe yatırılanlar (non-ICU) olarak iki gruba ayrıldı. Bulgular: Toplam 158 olgunun 86 (50%)’sı erkek idi. Yaş, total bilirubin, AST ve FIB-4 index yoğun bakım ünitesinde yatanlarda yoğun bakımda yatmayanlarla karşılaştırıldığında sırasıyla (p<0,001, p=0,002, p=0,003, p<0,001 ) idi. FIB-4 index hayatta kalmayanlarda daha yüsekti (p=0,002). FIB-4 skorunun COVİD-19 ciddiyetini ve mortaliteyi öngörmedeki etkisi ROC analizi ile değerlendirildiğinde hem yoğun bakımda yatan hemde hayatta kalmayanlarda anlamlı bulundu (sırasıyla AUC=0,705, 95%CI: 0.624-785, p<0,001; AUC=0,654, 95%CI:0,566-742, p=0,002). Hastalık şiddeti için FIB-4 indeks için cut-off değeri 2,19 olarak alındığında hastalık şiddetini öngörmede %70,0 duyarlılık ve %60 özgüllük bulunmuştur. Ayrıca, mortalite için FIB-4 indeksi için cut-off değeri 2,19 olarak alındığında, mortaliteyi öngörmede %71,2 duyarlılık ve %53 özgüllük bulunmuştur. Sonuç: FIB-4 indeksi yoğun bakım gerektiren COVİD-19 hastalarının cidiyetini ve mortaliteyi belirlemede bağımsız bir öngördürücüdür.

Anahtar Kelimeler

• COVİD-19
• FİB-4 İNDEX
• mortalite

Kaynakça

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