The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis
<i>Background:</i> Emerging evidence suggests that patients with metabolic (dysfunction) associated fatty liver disease (MAFLD) are prone to severe forms of coronavirus disease (COVID-19), especially those with underlying liver fibrosis. The aim of our study is to assess the association...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/5/434 |
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| author | Ovidiu P. Calapod Andreea M. Marin Minodora Onisai Laura C. Tribus Corina S. Pop Carmen Fierbinteanu-Braticevici |
| author_facet | Ovidiu P. Calapod Andreea M. Marin Minodora Onisai Laura C. Tribus Corina S. Pop Carmen Fierbinteanu-Braticevici |
| author_sort | Ovidiu P. Calapod |
| collection | DOAJ |
| description | <i>Background:</i> Emerging evidence suggests that patients with metabolic (dysfunction) associated fatty liver disease (MAFLD) are prone to severe forms of coronavirus disease (COVID-19), especially those with underlying liver fibrosis. The aim of our study is to assess the association of an increased FIB-4 score with COVID-19 disease prognosis. <i>Methods:</i> We performed a prospective study on hospitalized patients with known type II diabetes mellitus (T2DM) and confirmed COVID-19, with imaging evidence of liver steatosis within the last year or known diagnosis of MAFLD. All individuals were screened for liver fibrosis with a FIB-4 index. We evaluated the link between FIB-4 and disease prognosis. <i>Results:</i> Of 138 participants, 91.3% had MAFLD and 21.5% patients had a high risk of fibrosis. In the latter group of patients, the number of severe forms of disease, the hospital stay length, the rate of ICU admissions and the number of deaths reported registered a statistically significant increase. The independent predictors for developing severe forms of COVID-19 were obesity (odds ratio (OR), 3.24; 95% confidence interval (CI), <i>p</i> = 0.003), higher values of ferritin (OR-1.9; 95% CI, 1.17–8.29, <i>p</i> = 0.031) and of FIB-4 ≥ 3.25 (OR-4.89; 95% CI, 1.34–12.3, <i>p</i> = 0.02). <i>Conclusions:</i> Patients with high scores of FIB-4 have poor clinical outcomes and liver fibrosis may have a relevant prognostic role. Although the link between liver fibrosis and the prognosis of COVD-19 needs to be evaluated in further studies, screening for liver fibrosis with FIB-4 index, particularly in patients at risk, such as those with T2DM, will make a huge contribution to patient risk stratification. |
| first_indexed | 2024-03-10T11:46:52Z |
| format | Article |
| id | doaj.art-085713070a1d4304a22da8ed60369f90 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T11:46:52Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-085713070a1d4304a22da8ed60369f902023-11-21T17:57:45ZengMDPI AGMedicina1010-660X1648-91442021-04-0157543410.3390/medicina57050434The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease PrognosisOvidiu P. Calapod0Andreea M. Marin1Minodora Onisai2Laura C. Tribus3Corina S. Pop4Carmen Fierbinteanu-Braticevici5Gastroenterology Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, RomaniaGastroenterology Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, RomaniaHematology Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, RomaniaGastroenterology Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, RomaniaInternal Medicine Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, RomaniaGastroenterology Department, Emergency University Hospital of Bucharest, “Carol Davila” University of Medicine and Pharmacy, 050098 Bucharest, Romania<i>Background:</i> Emerging evidence suggests that patients with metabolic (dysfunction) associated fatty liver disease (MAFLD) are prone to severe forms of coronavirus disease (COVID-19), especially those with underlying liver fibrosis. The aim of our study is to assess the association of an increased FIB-4 score with COVID-19 disease prognosis. <i>Methods:</i> We performed a prospective study on hospitalized patients with known type II diabetes mellitus (T2DM) and confirmed COVID-19, with imaging evidence of liver steatosis within the last year or known diagnosis of MAFLD. All individuals were screened for liver fibrosis with a FIB-4 index. We evaluated the link between FIB-4 and disease prognosis. <i>Results:</i> Of 138 participants, 91.3% had MAFLD and 21.5% patients had a high risk of fibrosis. In the latter group of patients, the number of severe forms of disease, the hospital stay length, the rate of ICU admissions and the number of deaths reported registered a statistically significant increase. The independent predictors for developing severe forms of COVID-19 were obesity (odds ratio (OR), 3.24; 95% confidence interval (CI), <i>p</i> = 0.003), higher values of ferritin (OR-1.9; 95% CI, 1.17–8.29, <i>p</i> = 0.031) and of FIB-4 ≥ 3.25 (OR-4.89; 95% CI, 1.34–12.3, <i>p</i> = 0.02). <i>Conclusions:</i> Patients with high scores of FIB-4 have poor clinical outcomes and liver fibrosis may have a relevant prognostic role. Although the link between liver fibrosis and the prognosis of COVD-19 needs to be evaluated in further studies, screening for liver fibrosis with FIB-4 index, particularly in patients at risk, such as those with T2DM, will make a huge contribution to patient risk stratification.https://www.mdpi.com/1648-9144/57/5/434liverT2DMCOVID-19FIB-4 |
| spellingShingle | Ovidiu P. Calapod Andreea M. Marin Minodora Onisai Laura C. Tribus Corina S. Pop Carmen Fierbinteanu-Braticevici The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis Medicina liver T2DM COVID-19 FIB-4 |
| title | The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis |
| title_full | The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis |
| title_fullStr | The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis |
| title_full_unstemmed | The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis |
| title_short | The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis |
| title_sort | impact of increased fib 4 score in patients with type ii diabetes mellitus on covid 19 disease prognosis |
| topic | liver T2DM COVID-19 FIB-4 |
| url | https://www.mdpi.com/1648-9144/57/5/434 |
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