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

• Published in: International journal of clinical practice (Esher) 2022, Vol.2022, p.1734896-8
• Main Authors: Demir, Nurhan, Yüzbasıoglu, Bilgehan, Calhan, Turan, Ozturk, Savas
• Format: Article
• Language: English
• Subjects: Age; Blood platelets; Blood tests; Chronic obstructive pulmonary disease; Coronaviruses; COVID-19; Diabetes; Ferritin; Fibrosis; Hospitalization; Infections; Ischemia; Kinases; Leukocytes (neutrophilic); Liver cirrhosis; Liver diseases; Lymphocytes; Medical records; Metabolism; Mortality; Patients; Risk factors; Severe acute respiratory syndrome coronavirus 2; Ventilators
• ISSN: 1368-5031; 1742-1241
• DOI: 10.1155/2022/1734896

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: 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.