Observational studyThe Journal of infectious diseases2020
Elevation of Liver Fibrosis Index FIB-4 Is Associated With Poor Clinical Outcomes in Patients With COVID-19.
Observational study in The Journal of infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- The NAVETA obesity consensus tool: a multidimensional framework for clinical and patient-reported outcome assessment.Frontiers in endocrinology · 2025Guideline
- 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 & hepatology · 2022Pooled it
- Fibrosis-4 index and mortality in coronavirus disease 2019: a meta-analysis.European journal of gastroenterology & hepatology · 2021Pooled it
- Impact of cardiovascular disease on clinical outcomes in hospitalized patients with Covid-19: a systematic review and meta-analysis.Internal and emergency medicine · 2021Pooled it
- Radiologic correlation with fatty liver and adrenal adenoma using dual echo chemical shift magnetic resonance imaging.Abdominal radiology (New York) · 2025Article
- Disease activity and changes in the fibrosis-4 index in patients with rheumatoid arthritis treated with methotrexate for a short period.Archives of rheumatology · 2025Article
- FIB-4 Index Can Predict Mortality in Hospitalized Patients with COVID-19 Infection, Independent of CT Severity Score.Archives of Iranian medicine · 2025Article
- Prognostic Value of the Pretransplant Fibrosis-4 Index on Non-Relapse and Overall Mortality following Unrelated Single-Unit Cord Blood Transplantation in Adults.Acta haematologica · 2025Article
- Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk.The American journal of gastroenterology · 2024Article
- Article
- Chemerin Levels in COVID-19 Are More Affected by Underlying Diseases than by the Virus Infection Itself.Biomedicines · 2024Article
- Exploring autoantibodies as predictors of severe fibrosis or cirrhosis in metabolic dysfunction associated with steatotic liver disease.Canadian liver journal · 2024Article
- The FIB-4 scores in the emergency department to predict the outcomes of COVID-19 patients in taiwan.Heliyon · 2024Article
- Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease.World journal of hepatology · 2024Article
- First COVID-19 wave in the province of Bergamo, Italy: epidemiological and clinical characteristics, outcome and management of the first hospitalized patients.BMC infectious diseases · 2024Article
- QTc Prolongation to Predict Mortality in Patients Admitted with COVID-19 Infection: An Observational Study.Current vascular pharmacology · 2024Observational
- Metabolic-associated fatty liver disease and liver fibrosis scores as COVID-19 outcome predictors: a machine-learning application.Internal and emergency medicine · 2023Article
- Fib-4 score is able to predict intra-hospital mortality in 4 different SARS-COV2 waves.Internal and emergency medicine · 2023Article
- Clinical implications of COVID-19 in patients with metabolic-associated fatty liver disease.World journal of gastroenterology · 2023Review
- COVID-19 and hepatic injury: cellular and molecular mechanisms in diverse liver cells.World journal of gastroenterology · 2023Review
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 is a potentially severe disease caused by the recently described SARS-CoV-2. Whether liver fibrosis might be a relevant player in the natural history of COVID-19 is currently unknown. We aimed to evaluate the association between FIB-4 and the risk of progression to critical illness in middle-aged patients with COVID-19.
methodsIn this multicenter, retrospective study with prospective follow-up of 160 patients aged 35-65 years with COVID-19, FIB-4, clinical, and biochemical variables were collected at baseline. FIB-4 ≥2.67 defined patients with risk for advanced liver fibrosis.
resultsRisk for advanced fibrosis was estimated in 28.1% of patients. Patients with FIB-4 ≥2.67 more frequently required mechanical ventilation (37.8% vs 18.3%; P = .009). In multivariate analysis, FIB-4 ≥2.67 (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.30-8.92), cardiovascular risk factors (OR, 5.05; 95% CI, 1.90-13.39), previous respiratory diseases (OR, 4.54; 95% CI, 1.36-15.10), and C-reactive protein (OR, 1.01; 95% CI, 1.01-1.02) increased significantly the risk of ICU admission. Bootstrap confirmed FIB-4 as an independent risk factor.
conclusionsIn middle-aged patients with COVID-19, FIB-4 may have a prognostic role. The link between liver fibrosis and the natural history of COVID-19 should be evaluated in future studies.
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