tetano
Editor, Senior Moderator
PLoS One
. 2024 May 7;19(5):e0296495.
doi: 10.1371/journal.pone.0296495. eCollection 2024. Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy
Raffaele Galiero[SUP] 1 [/SUP], Giuseppe Loffredo[SUP] 1 [/SUP], Vittorio Simeon[SUP] 2 [/SUP], Alfredo Caturano[SUP] 1 [/SUP], Erica Vetrano[SUP] 1 [/SUP], Giulia Medicamento[SUP] 1 [/SUP], Maria Alfano[SUP] 1 [/SUP], Domenico Beccia[SUP] 1 [/SUP], Chiara Brin[SUP] 1 [/SUP], Sara Colantuoni[SUP] 1 [/SUP], Jessica Di Salvo[SUP] 1 [/SUP], Raffaella Epifani[SUP] 1 [/SUP], Riccardo Nevola[SUP] 1 3 [/SUP], Raffaele Marfella[SUP] 1 [/SUP], Celestino Sardu[SUP] 1 [/SUP], Carmine Coppola[SUP] 4 [/SUP], Ferdinando Scarano[SUP] 5 [/SUP], Paolo Maggi[SUP] 6 [/SUP], Cecilia Calabrese[SUP] 7 [/SUP], Pellegrino De Lucia Sposito[SUP] 8 [/SUP], Carolina Rescigno[SUP] 9 [/SUP], Costanza Sbreglia[SUP] 10 [/SUP], Fiorentino Fraganza[SUP] 11 [/SUP], Roberto Parrella[SUP] 12 [/SUP], Annamaria Romano[SUP] 13 [/SUP], Giosuele Calabria[SUP] 14 [/SUP], Benedetto Polverino[SUP] 15 [/SUP], Antonio Pagano[SUP] 16 [/SUP], Fabio Numis[SUP] 16 [/SUP], Carolina Bologna[SUP] 17 [/SUP], Mariagrazia Nunziata[SUP] 18 [/SUP], Vincenzo Esposito[SUP] 19 [/SUP], Nicola Coppola[SUP] 20 [/SUP], Nicola Maturo[SUP] 21 [/SUP], Rodolfo Nasti[SUP] 22 [/SUP], Pierpaolo Di Micco[SUP] 23 [/SUP], Alessandro Perrella[SUP] 24 [/SUP], Luigi Elio Adinolfi[SUP] 1 [/SUP], Paolo Chiodini[SUP] 2 [/SUP], Marina Di Domenico[SUP] 25 [/SUP], Luca Rinaldi[SUP] 1 [/SUP], Ferdinando Carlo Sasso[SUP] 1 [/SUP]; COVOCA Study Group
Affiliations
Background & aims: SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects.
Methods: This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.45<FIB-4<3.25; FIB-4>3.25), respectively group 1,2,3.
Results: At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.45<FIB-4<3.25 (24.1%, group 2) and 69 a FIB-4>3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.45<FIB-4<3.25 (34.4%, group 2) and 76 a FIB-4>3.25 (42.3%, group 3).
Conclusions: FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage.
. 2024 May 7;19(5):e0296495.
doi: 10.1371/journal.pone.0296495. eCollection 2024. Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy
Raffaele Galiero[SUP] 1 [/SUP], Giuseppe Loffredo[SUP] 1 [/SUP], Vittorio Simeon[SUP] 2 [/SUP], Alfredo Caturano[SUP] 1 [/SUP], Erica Vetrano[SUP] 1 [/SUP], Giulia Medicamento[SUP] 1 [/SUP], Maria Alfano[SUP] 1 [/SUP], Domenico Beccia[SUP] 1 [/SUP], Chiara Brin[SUP] 1 [/SUP], Sara Colantuoni[SUP] 1 [/SUP], Jessica Di Salvo[SUP] 1 [/SUP], Raffaella Epifani[SUP] 1 [/SUP], Riccardo Nevola[SUP] 1 3 [/SUP], Raffaele Marfella[SUP] 1 [/SUP], Celestino Sardu[SUP] 1 [/SUP], Carmine Coppola[SUP] 4 [/SUP], Ferdinando Scarano[SUP] 5 [/SUP], Paolo Maggi[SUP] 6 [/SUP], Cecilia Calabrese[SUP] 7 [/SUP], Pellegrino De Lucia Sposito[SUP] 8 [/SUP], Carolina Rescigno[SUP] 9 [/SUP], Costanza Sbreglia[SUP] 10 [/SUP], Fiorentino Fraganza[SUP] 11 [/SUP], Roberto Parrella[SUP] 12 [/SUP], Annamaria Romano[SUP] 13 [/SUP], Giosuele Calabria[SUP] 14 [/SUP], Benedetto Polverino[SUP] 15 [/SUP], Antonio Pagano[SUP] 16 [/SUP], Fabio Numis[SUP] 16 [/SUP], Carolina Bologna[SUP] 17 [/SUP], Mariagrazia Nunziata[SUP] 18 [/SUP], Vincenzo Esposito[SUP] 19 [/SUP], Nicola Coppola[SUP] 20 [/SUP], Nicola Maturo[SUP] 21 [/SUP], Rodolfo Nasti[SUP] 22 [/SUP], Pierpaolo Di Micco[SUP] 23 [/SUP], Alessandro Perrella[SUP] 24 [/SUP], Luigi Elio Adinolfi[SUP] 1 [/SUP], Paolo Chiodini[SUP] 2 [/SUP], Marina Di Domenico[SUP] 25 [/SUP], Luca Rinaldi[SUP] 1 [/SUP], Ferdinando Carlo Sasso[SUP] 1 [/SUP]; COVOCA Study Group
Affiliations
- PMID: 38713731
- PMCID: PMC11075870
- DOI: 10.1371/journal.pone.0296495
Background & aims: SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects.
Methods: This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.45<FIB-4<3.25; FIB-4>3.25), respectively group 1,2,3.
Results: At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.45<FIB-4<3.25 (24.1%, group 2) and 69 a FIB-4>3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.45<FIB-4<3.25 (34.4%, group 2) and 76 a FIB-4>3.25 (42.3%, group 3).
Conclusions: FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage.