ArticleJournal of clinical medicine2021
Liver Injury and Elevated FIB-4 Define a High-Risk Group in Patients with COVID-19.
Article in Journal of clinical medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 22 citations in OpenAlex.
- FIB-4, APRI, and ALRI as Predictors of COVID-19 Outcomes: Insights from a Large-Scale Study.Diagnostics (Basel, Switzerland) · 2025Article
- Selecting Targets for Molecular Imaging of Gastric Cancer: An Immunohistochemical Evaluation.Molecular diagnosis & therapy · 2025Article
- Liver dysfunction in adults with COVID-19 infection: A longitudinal study with transient elastography evaluation.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- The FIB-4 scores in the emergency department to predict the outcomes of COVID-19 patients in taiwan.Heliyon · 2024Article
- Observational
- Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre.Pharmaceuticals (Basel, Switzerland) · 2023Article
- An Updated Systematic Review and Meta-Analysis of the Association between the De Ritis Ratio and Disease Severity and Mortality in Patients with COVID-19.Life (Basel, Switzerland) · 2023Review
- The Role of APRI, FIB-4, and SAD-60 Scores as Predictors of Mortality in COVID-19 Patients.Infectious diseases & clinical microbiology · 2023Article
- May 2022 acute hepatitis outbreak, is there a role for COVID-19 and other viruses?World journal of hepatology · 2023Review
- Prevention, diagnostic evaluation, management and prognostic implications of liver disease in critically ill patients with COVID-19.World journal of clinical cases · 2023Review
- Article
- Quantitative assessment of fibrosis-4 score and adverse clinical outcomes in patients with COVID-19.Science China. Life sciences · 2022Article
- Liver Fibrosis Indices Predict the Severity of SARS-CoV-2 Infection.Journal of clinical medicine · 2022Article
- Usefulness of fibrosis-4 (FIB-4) score and metabolic alterations in the prediction of SARS-CoV-2 severity.Internal and emergency medicine · 2022Article
- Fibrosis-4 (FIB-4) Index and mortality in COVID-19 patients admitted to the emergency department.Internal and emergency medicine · 2022Article
- Acute Liver Failure and Acute-on-Chronic Liver Failure in COVID-19 Era.Journal of clinical medicine · 2022Article
- Prevalence and Prognostic Importance of High Fibrosis-4 Index in COVID-19 Patients.International journal of clinical practice · 2022Article
Corrections and comments
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Authors and funding
21 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Liver involvement in Coronavirus Disease 2019 (COVID-19) has been widely documented. However, data regarding liver-related prognosis are scarce and heterogeneous. The current study aims to evaluate the role of abnormal liver tests and incidental elevations of non-invasive fibrosis estimators on the prognosis of hospitalized COVID-19 patients. We conducted a retrospective cohort study to investigate the impact of elevated liver tests, non-invasive fibrosis estimators (the Fibrosis-4 (FIB-4), Forns, APRI scores, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio), and the presence of computed tomography (CT)-documented liver steatosis on mortality in patients with moderate and severe COVID-19, with no prior liver disease history. A total of 370 consecutive patients were included, of which 289 patients (72.9%) had abnormal liver biochemistry on admission. Non-survivors had significantly higher FIB-4, Forns, APRI scores, and a higher AST/ALT ratio. On multivariate analysis, severe FIB-4 (exceeding 3.25) and elevated AST were independently associated with mortality. Severe FIB-4 had an area under the receiver operating characteristic (AUROC) of 0.73 for predicting survival. The presence of steatosis was not associated with a worse outcome. Patients with abnormal liver biochemistry on arrival might be susceptible to a worse disease outcome. An FIB-4 score above the threshold of 3.25, suggestive of the presence of fibrosis, is associated with higher mortality in hospitalized COVID-19 patients.
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