Hepatic injury biomarkers in COVID-19
Introduction and Objectives: : C-reactive protein (CRP) and D-dimer have been shown to be predictors of severity in patients with COVID-19. The FIB-4 and APRI scoring systems are tools calculated using routine laboratory parameters that allow non-invasive evaluation of liver fibrosis. Some studies h...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124002539 |
| _version_ | 1797272469383413760 |
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| author | Diana K. Tapia-Calderón Ana I. Tornel-Avelar Francisco A. Félix-Téllez Lydia A. Mercado-Jáuregui Liliana E. Ramos-Villalobos Bladimir Diaz-Villavicencio Monserrat Lazcano-Becerra Rodrigo Escobedo-Sánchez Edgar S. García-Jiménez José A. Velarde-Ruiz Velasco |
| author_facet | Diana K. Tapia-Calderón Ana I. Tornel-Avelar Francisco A. Félix-Téllez Lydia A. Mercado-Jáuregui Liliana E. Ramos-Villalobos Bladimir Diaz-Villavicencio Monserrat Lazcano-Becerra Rodrigo Escobedo-Sánchez Edgar S. García-Jiménez José A. Velarde-Ruiz Velasco |
| author_sort | Diana K. Tapia-Calderón |
| collection | DOAJ |
| description | Introduction and Objectives: : C-reactive protein (CRP) and D-dimer have been shown to be predictors of severity in patients with COVID-19. The FIB-4 and APRI scoring systems are tools calculated using routine laboratory parameters that allow non-invasive evaluation of liver fibrosis. Some studies have demonstrated that the parameters comprising these scores predict mortality in COVID-19. The objective of this study was to determine the role of various liver injury biomarkers in stratifying the severity of hospitalized patients with COVID-19. Materials and Patients: Analytical and retrospective study. Patients with COVID-19 were included, while those with liver disease were excluded. A receiver operating characteristic (ROC) analysis with 95% confidence intervals (CI) was performed to determine the predictive performance of FIB-4, APRI, D-dimer, and CRP in terms of the need for invasive mechanical ventilation (IMV) and mortality. Results: A total of 448 hospitalized patients with COVID-19 were included in the study. 68.2% were male, with a mean age of 56.27 ± 14.7 years. 35.1% had systemic arterial hypertension, 29.2% had diabetes mellitus, 6% had cancer, 5% had chronic obstructive pulmonary disease, and 3.3% had chronic kidney disease. 21.4% required nasal cannula support, 29.4% required mask with reservoir, 35.5% required high-flow oxygen therapy, and 13.1% required IMV. 48% had severe disease, and 28.1% died. ROC analysis with 95% CI revealed that the best predictor of the need for IMV was the FIB-4 index, with an AUC of 0.637 (95% CI 0.545 - 0.732, p= 0.003), followed by APRI with an AUC of 0.596 (95% CI 0.504-0.687, p=0.04). The best predictor of mortality was FIB-4 with an AUC of 0.689 (95% CI 0.620 - 0.785, p= <0.001), followed by D-dimer with an AUC of 0.608 (95% CI 0.528 - 0.688, p= 0.041). Conclusions: The application of the FIB-4 index with a cutoff point of ≥1.9 predicts IMV and mortality in SARS-CoV-2 infection and is superior to the standard severity biomarkers (CRP and D-dimer). |
| first_indexed | 2024-03-07T14:29:48Z |
| format | Article |
| id | doaj.art-24ca2ab951784b99b34bd445bea4b7cc |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-03-07T14:29:48Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-24ca2ab951784b99b34bd445bea4b7cc2024-03-06T05:26:16ZengElsevierAnnals of Hepatology1665-26812024-02-0129101459Hepatic injury biomarkers in COVID-19Diana K. Tapia-Calderón0Ana I. Tornel-Avelar1Francisco A. Félix-Téllez2Lydia A. Mercado-Jáuregui3Liliana E. Ramos-Villalobos4Bladimir Diaz-Villavicencio5Monserrat Lazcano-Becerra6Rodrigo Escobedo-Sánchez7Edgar S. García-Jiménez8José A. Velarde-Ruiz Velasco9Gastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoInternal Medicine. Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoInfectology. Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoGastroenterology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, JaliscoIntroduction and Objectives: : C-reactive protein (CRP) and D-dimer have been shown to be predictors of severity in patients with COVID-19. The FIB-4 and APRI scoring systems are tools calculated using routine laboratory parameters that allow non-invasive evaluation of liver fibrosis. Some studies have demonstrated that the parameters comprising these scores predict mortality in COVID-19. The objective of this study was to determine the role of various liver injury biomarkers in stratifying the severity of hospitalized patients with COVID-19. Materials and Patients: Analytical and retrospective study. Patients with COVID-19 were included, while those with liver disease were excluded. A receiver operating characteristic (ROC) analysis with 95% confidence intervals (CI) was performed to determine the predictive performance of FIB-4, APRI, D-dimer, and CRP in terms of the need for invasive mechanical ventilation (IMV) and mortality. Results: A total of 448 hospitalized patients with COVID-19 were included in the study. 68.2% were male, with a mean age of 56.27 ± 14.7 years. 35.1% had systemic arterial hypertension, 29.2% had diabetes mellitus, 6% had cancer, 5% had chronic obstructive pulmonary disease, and 3.3% had chronic kidney disease. 21.4% required nasal cannula support, 29.4% required mask with reservoir, 35.5% required high-flow oxygen therapy, and 13.1% required IMV. 48% had severe disease, and 28.1% died. ROC analysis with 95% CI revealed that the best predictor of the need for IMV was the FIB-4 index, with an AUC of 0.637 (95% CI 0.545 - 0.732, p= 0.003), followed by APRI with an AUC of 0.596 (95% CI 0.504-0.687, p=0.04). The best predictor of mortality was FIB-4 with an AUC of 0.689 (95% CI 0.620 - 0.785, p= <0.001), followed by D-dimer with an AUC of 0.608 (95% CI 0.528 - 0.688, p= 0.041). Conclusions: The application of the FIB-4 index with a cutoff point of ≥1.9 predicts IMV and mortality in SARS-CoV-2 infection and is superior to the standard severity biomarkers (CRP and D-dimer).http://www.sciencedirect.com/science/article/pii/S1665268124002539 |
| spellingShingle | Diana K. Tapia-Calderón Ana I. Tornel-Avelar Francisco A. Félix-Téllez Lydia A. Mercado-Jáuregui Liliana E. Ramos-Villalobos Bladimir Diaz-Villavicencio Monserrat Lazcano-Becerra Rodrigo Escobedo-Sánchez Edgar S. García-Jiménez José A. Velarde-Ruiz Velasco Hepatic injury biomarkers in COVID-19 Annals of Hepatology |
| title | Hepatic injury biomarkers in COVID-19 |
| title_full | Hepatic injury biomarkers in COVID-19 |
| title_fullStr | Hepatic injury biomarkers in COVID-19 |
| title_full_unstemmed | Hepatic injury biomarkers in COVID-19 |
| title_short | Hepatic injury biomarkers in COVID-19 |
| title_sort | hepatic injury biomarkers in covid 19 |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124002539 |
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