Early elevation of FIB-4 liver fibrosis score is associated with adverse outcomes among patients with COVID-19

November 9, 2020

Fangfei Xiang, Jing Sun, Po-Hung Chen, Peijin Han, Haipeng Zheng, Shuijiang Cai, Gregory D Kirk

Clinical Infectious Diseases

The authors evaluated the association of FIB-4 scores in an early stage of SARS-CoV-2 infection with adverse outcomes during hospitalization. They conducted a retrospective cohort study of adults with confirmed SARS-CoV-2 infection admitted to a specialized infectious disease hospital in Guangdong, China, from January 20 to February 10, 2020. Among all patients, 57.3 % had FIB-4 <1.45, 33.3% had values ​​between 1.45-3.25 and 12.0% had FIB-4> 3.25. Although there were fewer patients in the higher groups For FIB-4, higher FIB-4 scores on admission were associated with an increased risk of ventilator use, high oxygen flow, increased risk of progression to severe disease, and death or prolonged hospitalization. Regarding clinical presentation, patients with higher FIB-4 scores were more likely to present fever and fatigue on admission; other symptoms were not related to FIB-4 scores. These results suggested that underlying liver fibrosis and FIB-4 score may be early predictors of adverse outcomes among COVID-19 patients, and patients with both chronic liver disease may have an increased susceptibility to progressive disease. FIB-4 is a sensitive, inexpensive, and non-invasive marker for predicting disease progression in COVID-19 patients.

Xiang G., Sun J., Chen P., Han P. Early elevation of FIB-4 liver fibrosis score is associated with adverse outcomes among patients with COVID-19. Clinical Infectious Diseases 2020, https://doi.org/10.1093/cid/ciaa1710

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