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The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on Covid-19 Disease Prognosis.
Medicina (Kaunas). 2021 Apr 30; 57(5)M

Abstract

Background:

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.

Methods:

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.

Results:

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), p = 0.003), higher values of ferritin (OR-1.9; 95% CI, 1.17-8.29, p = 0.031) and of FIB-4 ≥ 3.25 (OR-4.89; 95% CI, 1.34-12.3, p = 0.02).

Conclusions:

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.

Authors+Show Affiliations

Gastroenterology Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.Gastroenterology Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.Hematology Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.Gastroenterology Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.Internal Medicine Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.Gastroenterology Department, Emergency University Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, 050098 Bucharest, Romania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33946377

Citation

Calapod, Ovidiu P., et al. "The Impact of Increased Fib-4 Score in Patients With Type II Diabetes Mellitus On Covid-19 Disease Prognosis." Medicina (Kaunas, Lithuania), vol. 57, no. 5, 2021.
Calapod OP, Marin AM, Onisai M, et al. The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on Covid-19 Disease Prognosis. Medicina (Kaunas). 2021;57(5).
Calapod, O. P., Marin, A. M., Onisai, M., Tribus, L. C., Pop, C. S., & Fierbinteanu-Braticevici, C. (2021). The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on Covid-19 Disease Prognosis. Medicina (Kaunas, Lithuania), 57(5). https://doi.org/10.3390/medicina57050434
Calapod OP, et al. The Impact of Increased Fib-4 Score in Patients With Type II Diabetes Mellitus On Covid-19 Disease Prognosis. Medicina (Kaunas). 2021 Apr 30;57(5) PubMed PMID: 33946377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on Covid-19 Disease Prognosis. AU - Calapod,Ovidiu P, AU - Marin,Andreea M, AU - Onisai,Minodora, AU - Tribus,Laura C, AU - Pop,Corina S, AU - Fierbinteanu-Braticevici,Carmen, Y1 - 2021/04/30/ PY - 2021/04/20/received PY - 2021/04/26/revised PY - 2021/04/29/accepted PY - 2021/5/5/entrez PY - 2021/5/6/pubmed PY - 2021/5/15/medline KW - COVID-19 KW - FIB-4 KW - T2DM KW - liver JF - Medicina (Kaunas, Lithuania) JO - Medicina (Kaunas) VL - 57 IS - 5 N2 - Background: 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. Methods: 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. Results: 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), p = 0.003), higher values of ferritin (OR-1.9; 95% CI, 1.17-8.29, p = 0.031) and of FIB-4 ≥ 3.25 (OR-4.89; 95% CI, 1.34-12.3, p = 0.02). Conclusions: 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. SN - 1648-9144 UR - https://www.unboundmedicine.com/medline/citation/33946377/The_Impact_of_Increased_Fib_4_Score_in_Patients_with_Type_II_Diabetes_Mellitus_on_Covid_19_Disease_Prognosis_ L2 - https://www.mdpi.com/resolver?pii=medicina57050434 DB - PRIME DP - Unbound Medicine ER -