The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study
Background Patients with chronic liver disease (CLD) have a higher risk of mortality when infected with severe acute respiratory syndrome coronavirus 2. Although the fibrosis-4 (FIB-4) index, aspartate aminotransferase-to-platelet ratio index (APRI), and albumin-bilirubin grade (ALBI) score can pred...
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| Format: | Article |
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PeerJ Inc.
2023-12-01
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| Online Access: | https://peerj.com/articles/16582.pdf |
| _version_ | 1797402884701159424 |
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| author | Pei-Jui Wu I-Che Feng Chih-Cheng Lai Chung-Han Ho Wei-Chih Kan Ming-Jen Sheu Hsing-Tao Kuo |
| author_facet | Pei-Jui Wu I-Che Feng Chih-Cheng Lai Chung-Han Ho Wei-Chih Kan Ming-Jen Sheu Hsing-Tao Kuo |
| author_sort | Pei-Jui Wu |
| collection | DOAJ |
| description | Background Patients with chronic liver disease (CLD) have a higher risk of mortality when infected with severe acute respiratory syndrome coronavirus 2. Although the fibrosis-4 (FIB-4) index, aspartate aminotransferase-to-platelet ratio index (APRI), and albumin-bilirubin grade (ALBI) score can predict mortality in CLD, their correlation with the clinical outcomes of CLD patients with coronavirus disease 2019 (COVID-19) is unclear. This study aimed to investigate the association between the liver severity and the mortality in hospitalized patients with non-cirrhotic CLD and COVID-19. Methods This retrospective study analyzed 231 patients with non-cirrhotic CLD and COVID-19. Clinical characteristics, laboratory data, including liver status indices, and clinical outcomes were assessed to determine the correlation between liver status indices and the mortality among patients with non-cirrhotic CLD and COVID-19. Results Non-survivors had higher levels of prothrombin time-international normalized ratio (PT-INR), alanine aminotransferase, aspartate aminotransferase, and high-sensitivity C-reactive protein (hs-CRP) and lower albumin levels. Multivariable analysis showed that ALBI grade 3 (odds ratio (OR): 22.80, 95% confidence interval (CI) [1.70–305.38], p = 0.018), FIB-4 index ≥ 3.25 (OR: 10.62, 95% CI [1.12–100.31], p = 0.039), PT-INR (OR: 19.81, 95% CI [1.31–299.49], p = 0.031), hs-CRP (OR: 1.02, 95% CI [1.01–1.02], p = 0.001), albumin level (OR: 0.08, 95% CI [0.02–0.39], p = 0.002), and use of vasopressors (OR: 4.98, 95% CI [1.27–19.46], p = 0.021) were associated with the mortality. Conclusion The ALBI grade 3 and FIB-4 index ≥ 3.25, higher PT-INR, hsCRP levels and lower albumin levels could be associated with mortality in non-cirrhotic CLD patients with COVID-19. Clinicians could assess the ALBI grade, FIB-4 index, PT-INR, hs-CRP, and albumin levels of patients with non-cirrhotic CLD upon admission. |
| first_indexed | 2024-03-09T02:30:40Z |
| format | Article |
| id | doaj.art-8128c7e79a1a407586b83ab40a25e4d1 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T02:30:40Z |
| publishDate | 2023-12-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
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| spelling | doaj.art-8128c7e79a1a407586b83ab40a25e4d12023-12-06T15:06:15ZengPeerJ Inc.PeerJ2167-83592023-12-0111e1658210.7717/peerj.16582The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center studyPei-Jui Wu0I-Che Feng1Chih-Cheng Lai2Chung-Han Ho3Wei-Chih Kan4Ming-Jen Sheu5Hsing-Tao Kuo6Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDepartment of Hospital Medicine, Chi Mei Medical Center, Tainan, TaiwanDepartment of Medical Research, Chi Mei Medical Center, Tainan, TaiwanDepartment of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanDivision of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, TaiwanBackground Patients with chronic liver disease (CLD) have a higher risk of mortality when infected with severe acute respiratory syndrome coronavirus 2. Although the fibrosis-4 (FIB-4) index, aspartate aminotransferase-to-platelet ratio index (APRI), and albumin-bilirubin grade (ALBI) score can predict mortality in CLD, their correlation with the clinical outcomes of CLD patients with coronavirus disease 2019 (COVID-19) is unclear. This study aimed to investigate the association between the liver severity and the mortality in hospitalized patients with non-cirrhotic CLD and COVID-19. Methods This retrospective study analyzed 231 patients with non-cirrhotic CLD and COVID-19. Clinical characteristics, laboratory data, including liver status indices, and clinical outcomes were assessed to determine the correlation between liver status indices and the mortality among patients with non-cirrhotic CLD and COVID-19. Results Non-survivors had higher levels of prothrombin time-international normalized ratio (PT-INR), alanine aminotransferase, aspartate aminotransferase, and high-sensitivity C-reactive protein (hs-CRP) and lower albumin levels. Multivariable analysis showed that ALBI grade 3 (odds ratio (OR): 22.80, 95% confidence interval (CI) [1.70–305.38], p = 0.018), FIB-4 index ≥ 3.25 (OR: 10.62, 95% CI [1.12–100.31], p = 0.039), PT-INR (OR: 19.81, 95% CI [1.31–299.49], p = 0.031), hs-CRP (OR: 1.02, 95% CI [1.01–1.02], p = 0.001), albumin level (OR: 0.08, 95% CI [0.02–0.39], p = 0.002), and use of vasopressors (OR: 4.98, 95% CI [1.27–19.46], p = 0.021) were associated with the mortality. Conclusion The ALBI grade 3 and FIB-4 index ≥ 3.25, higher PT-INR, hsCRP levels and lower albumin levels could be associated with mortality in non-cirrhotic CLD patients with COVID-19. Clinicians could assess the ALBI grade, FIB-4 index, PT-INR, hs-CRP, and albumin levels of patients with non-cirrhotic CLD upon admission.https://peerj.com/articles/16582.pdfALBIAPRICLDCOVID-19FIB-4Non-cirrhotic chronic liver disease |
| spellingShingle | Pei-Jui Wu I-Che Feng Chih-Cheng Lai Chung-Han Ho Wei-Chih Kan Ming-Jen Sheu Hsing-Tao Kuo The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study PeerJ ALBI APRI CLD COVID-19 FIB-4 Non-cirrhotic chronic liver disease |
| title | The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study |
| title_full | The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study |
| title_fullStr | The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study |
| title_full_unstemmed | The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study |
| title_short | The mortality of hospitalized patients with COVID-19 and non-cirrhotic chronic liver disease: a retrospective multi-center study |
| title_sort | mortality of hospitalized patients with covid 19 and non cirrhotic chronic liver disease a retrospective multi center study |
| topic | ALBI APRI CLD COVID-19 FIB-4 Non-cirrhotic chronic liver disease |
| url | https://peerj.com/articles/16582.pdf |
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