학술논문
Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy.
Document Type
article
Author
Raffaele Galiero; Giuseppe Loffredo; Vittorio Simeon; Alfredo Caturano; Erica Vetrano; Giulia Medicamento; Maria Alfano; Domenico Beccia; Chiara Brin; Sara Colantuoni; Jessica Di Salvo; Raffaella Epifani; Riccardo Nevola; Raffaele Marfella; Celestino Sardu; Carmine Coppola; Ferdinando Scarano; Paolo Maggi; Cecilia Calabrese; Pellegrino De Lucia Sposito; Carolina Rescigno; Costanza Sbreglia; Fiorentino Fraganza; Roberto Parrella; Annamaria Romano; Giosuele Calabria; Benedetto Polverino; Antonio Pagano; Fabio Numis; Carolina Bologna; Mariagrazia Nunziata; Vincenzo Esposito; Nicola Coppola; Nicola Maturo; Rodolfo Nasti; Pierpaolo Di Micco; Alessandro Perrella; Luigi Elio Adinolfi; Paolo Chiodini; Marina Di Domenico; Luca Rinaldi; Ferdinando Carlo Sasso; COVOCA Study Group
Source
PLoS ONE, Vol 19, Iss 5, p e0296495 (2024)
Subject
Language
English
ISSN
1932-6203
Abstract
Background & aimsSARS-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.MethodsThis 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-43.25), respectively group 1,2,3.ResultsAt 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, p3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-43.25 (42.3%, group 3).ConclusionsFIB-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.