Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis.
Can J Gastroenterol Hepatol
; 2022: 7235860, 2022.
Article
in English
| MEDLINE | ID: covidwho-1770044
ABSTRACT
Methods:
We identified relevant cohort studies that assessed the relationship between liver fibrosis scores (e.g., FIB-4, NAFLD fibrosis score (NFS), and aspartate aminotransferase to platelet ratio index (APRI)) and associated prognosis outcomes by searching the PubMed, EMBASE, and medRxiv databases. The potential dose-response effect was performed using a stage robust error meta-regression.Results:
Sixteen studies with 8,736 hospitalized patients with COVID-19 were included. One-point score in FIB-4 increase was significantly associated with increased mechanical ventilation (RR 2.23, 95% CI 1.37-3.65, P=0.001), severe COVID-19 (RR 1.82, 95% CI 1.53-2.16, P < 0.001), and death (RR 1.47, 95% CI 1.31-1.65, P < 0.001), rather than hospitalization (RR 1.35, 95% CI 0.72-2.56, P=0.35). Furthermore, there is a significant positive linear relationship between FIB-4 and severe COVID-19 (P nonlinearity=0.12) and mortality (P nonlinearity=0.18). Regarding other liver scores, one unit elevation in APRI increased the risk of death by 178% (RR 2.78, 95% CI 1.10-6.99, P=0.03). Higher NFS (≥-1.5) and Forns index were associated with increased risk of severe COVID-19 and COVID-19-associated death.Conclusion:
Our dose-response meta-analysis suggests high liver fibrosis scores are associated with worse prognosis in patients with COVID-19. For patients with COVID-19 at admission, especially for those with coexisting chronic liver diseases, assessment of liver fibrosis scores might be useful for identifying high risk of developing severe COVID-19 cases and worse outcomes.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Non-alcoholic Fatty Liver Disease
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Humans
Language:
English
Journal:
Can J Gastroenterol Hepatol
Year:
2022
Document Type:
Article
Affiliation country:
2022
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