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Fibrosis-4 Predicts the Need for Mechanical Ventilation in a National Multiethnic Cohort of Corona Virus Disease 2019.
Sterling, Richard K; Shin, Dongho; Shin, Yongyun; French, Evan; Stevens, Michael P; Bajaj, Jasmohan S; DeWit, Marjolein; Sanyal, Arun J.
  • Sterling RK; Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA, USA.
  • Shin D; Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
  • Shin Y; Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
  • French E; C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.
  • Stevens MP; Division of Infectious Diseases Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
  • Bajaj JS; Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA, USA.
  • DeWit M; Division of Pulmonary Medicine and Critical Care, Virginia Commonwealth University, Richmond, VA, USA.
  • Sanyal AJ; Division of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA, USA.
Hepatol Commun ; 5(9): 1605-1615, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1400821
ABSTRACT
Simple tests of routine data are needed for those with severe acute respiratory syndrome coronavirus 2, which causes corona virus disease 2019 (COVID-19), to help identify those who may need mechanical ventilation (MV). In this study, we aimed to determine if fibrosis-4 (FIB-4) is associated with the need for MV in patients with COVID-19 and if there is an association to determine the optimal FIB-4 cutoff. This was a retrospective, national, multiethnic cohort study of adults seen in an ambulatory or emergency department setting who were diagnosed with COVID-19. We used the TriNetX platform for analysis. Measures included demographics, comorbid diseases, and routine laboratory tests. A total of 4,901 patients with COVID-19 were included. Patients had a mean age of 56, 48% were women, 42% were obese, 38% were white, 40% were black, 15% had cardiac disease, 39% had diabetes mellitus, 20% had liver disease, and 50% had respiratory disease. The need for MV was 6%. The optimal FIB-4 cutoff for the need for MV was 3.04 (area under the curve, 0.735), which had sensitivity, specificity, and positive and negative predictive values of 42%, 77%, 11%, and 95%, respectively, with 93% accuracy. When stratified by race, increased FIB-4 remained associated with the need for MV in both white and black patients.

Conclusion:

FIB-4 can be used by frontline providers to identify patients that may require MV.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Hepatol Commun Year: 2021 Document Type: Article Affiliation country: Hep4.1737

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Hepatol Commun Year: 2021 Document Type: Article Affiliation country: Hep4.1737