Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis
Background and Aim. The relationship between liver fibrosis scores and clinical outcomes in patients with COVID-19 is not compressively assessed. Methods. We identified relevant cohort studies that assessed the relationship between liver fibrosis scores (e.g., FIB-4, NAFLD fibrosis score (NFS), and...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2022/7235860 |
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| author | Menglu Liu Kaibo Mei Ziqi Tan Shan Huang Fuwei Liu Chao Deng Jianyong Ma Peng Yu Xiao Liu |
| author_facet | Menglu Liu Kaibo Mei Ziqi Tan Shan Huang Fuwei Liu Chao Deng Jianyong Ma Peng Yu Xiao Liu |
| author_sort | Menglu Liu |
| collection | DOAJ |
| description | Background and Aim. The relationship between liver fibrosis scores and clinical outcomes in patients with COVID-19 is not compressively assessed. Methods. We identified relevant cohort studies that assessed the relationship between liver fibrosis scores (e.g., FIB-4, NAFLD fibrosis score (NFS), and aspartate aminotransferase to platelet ratio index (APRI)) and associated prognosis outcomes by searching the PubMed, EMBASE, and medRxiv databases. The potential dose-response effect was performed using a stage robust error meta-regression. Results. Sixteen studies with 8,736 hospitalized patients with COVID-19 were included. One-point score in FIB-4 increase was significantly associated with increased mechanical ventilation (RR: 2.23, 95% CI: 1.37–3.65, P=0.001), severe COVID-19 (RR: 1.82, 95% CI: 1.53–2.16, P<0.001), and death (RR: 1.47, 95% CI: 1.31–1.65, P<0.001), rather than hospitalization (RR: 1.35, 95% CI: 0.72–2.56, P=0.35). Furthermore, there is a significant positive linear relationship between FIB-4 and severe COVID-19 (Pnonlinearity=0.12) and mortality (Pnonlinearity=0.18). Regarding other liver scores, one unit elevation in APRI increased the risk of death by 178% (RR: 2.78, 95% CI: 1.10–6.99, P=0.03). Higher NFS (≥−1.5) and Forns index were associated with increased risk of severe COVID-19 and COVID-19-associated death. Conclusion. Our dose-response meta-analysis suggests high liver fibrosis scores are associated with worse prognosis in patients with COVID-19. For patients with COVID-19 at admission, especially for those with coexisting chronic liver diseases, assessment of liver fibrosis scores might be useful for identifying high risk of developing severe COVID-19 cases and worse outcomes. |
| format | Article |
| id | doaj-art-2fd50cf462c04855ae20848607de0805 |
| institution | Kabale University |
| issn | 2291-2797 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-2fd50cf462c04855ae20848607de08052025-02-03T06:01:17ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27972022-01-01202210.1155/2022/7235860Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-AnalysisMenglu Liu0Kaibo Mei1Ziqi Tan2Shan Huang3Fuwei Liu4Chao Deng5Jianyong Ma6Peng Yu7Xiao Liu8Department of CardiologyDepartment of AnesthesiologyDepartment of EndocrineDepartment of PsychiatryDepartment of CardiologyDepartment of CardiologyDepartment of Pharmacology and Systems PhysiologyDepartment of EndocrineInstitute for the Study of Endocrinology and Metabolism in JiangxiBackground and Aim. The relationship between liver fibrosis scores and clinical outcomes in patients with COVID-19 is not compressively assessed. Methods. We identified relevant cohort studies that assessed the relationship between liver fibrosis scores (e.g., FIB-4, NAFLD fibrosis score (NFS), and aspartate aminotransferase to platelet ratio index (APRI)) and associated prognosis outcomes by searching the PubMed, EMBASE, and medRxiv databases. The potential dose-response effect was performed using a stage robust error meta-regression. Results. Sixteen studies with 8,736 hospitalized patients with COVID-19 were included. One-point score in FIB-4 increase was significantly associated with increased mechanical ventilation (RR: 2.23, 95% CI: 1.37–3.65, P=0.001), severe COVID-19 (RR: 1.82, 95% CI: 1.53–2.16, P<0.001), and death (RR: 1.47, 95% CI: 1.31–1.65, P<0.001), rather than hospitalization (RR: 1.35, 95% CI: 0.72–2.56, P=0.35). Furthermore, there is a significant positive linear relationship between FIB-4 and severe COVID-19 (Pnonlinearity=0.12) and mortality (Pnonlinearity=0.18). Regarding other liver scores, one unit elevation in APRI increased the risk of death by 178% (RR: 2.78, 95% CI: 1.10–6.99, P=0.03). Higher NFS (≥−1.5) and Forns index were associated with increased risk of severe COVID-19 and COVID-19-associated death. Conclusion. Our dose-response meta-analysis suggests high liver fibrosis scores are associated with worse prognosis in patients with COVID-19. For patients with COVID-19 at admission, especially for those with coexisting chronic liver diseases, assessment of liver fibrosis scores might be useful for identifying high risk of developing severe COVID-19 cases and worse outcomes.http://dx.doi.org/10.1155/2022/7235860 |
| spellingShingle | Menglu Liu Kaibo Mei Ziqi Tan Shan Huang Fuwei Liu Chao Deng Jianyong Ma Peng Yu Xiao Liu Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis Canadian Journal of Gastroenterology and Hepatology |
| title | Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis |
| title_full | Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis |
| title_fullStr | Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis |
| title_full_unstemmed | Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis |
| title_short | Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis |
| title_sort | liver fibrosis scores and hospitalization mechanical ventilation severity and death in patients with covid 19 a systematic review and dose response meta analysis |
| url | http://dx.doi.org/10.1155/2022/7235860 |
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