The Relationship of Elevated Hepatic Fibrosis-4 Index Score with Pneumonia Severity Index and in Hospital Mortality Among COVID-19 Patients Admitted to Intensive Care Unit/Yogun Bakima Yatirilan COVID-19 Hastalarinda Erken Donemde Bakilan Yuksek Hepatik Fibrozis-4 Skoru ile Pnomoni Ciddiyet Indeksi ve Hastane Ici Mortalite Arasindaki Iliskinin Arastirilmasi

• Published in: Medical journal of Bakirköy Vol. 18; no. 1; p. 52
• Main Authors: Demir, Esra, Gungor, Hande, Erdogan, Cem, Olmuscelik, Oktay, Cakmak, Rumeysa, Yildirim, Aysegul
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01-03-2022
• Subjects: Care and treatment; Complications and side effects; Fibrosis; Turkey
• ISSN: 1305-9319
• DOI: 10.4274/BMJ.galenos.2022.2021.12-5

Objective: We investigated the relationship hepatic fibrosis-4 (FIB-4) index score calculated in the early period and pneumonia severity index (PSI) and in-hospital mortality in patients hospitalized in the intensive care unit (ICU) due to new severe acute respiratory syndrome coronavirus-2 infection. Methods: Seventy six consecutive patients diagnosed with coronavirus disease-2019 (COVID-19), hospitalized in the ICU due to hypoxemia, and selected consecutively were included. COVID-19 infection was diagnosed using real-time reverse transcription-polymerase chain reaction (RT-PCR) in nose and throat swab samples. The diagnosis of pneumonia was confirmed by showing typical ground-glass opacities and areas of subsegmental consolidation in lung computed tomography examinations of patients previously diagnosed with COVID-19 by RT-PCR. Hepatic FIB-4 index score and PSI score was calculated separately for each patient. In the statistical method, the independent samples t-test and Mann-Whitney U test were used to compare quantitative data. A chi-square test was used to compare qualitative data. Results: The FIB-4 value and PSI value were significantly higher (p<0.05) in the mortality group than in the non-mortality group. Also, there was no significant statistical difference between the two groups in terms of the other laboratory parameters (p>0.05) FIB-4 value was significantly predictive [under the curve 0.835 (0.742- 0.929)] in differentiating patients with and without mortality. For a cut-off value of 5.4, FIB-4 had a sensitivity of 60.6%, positive predictive of 95.2%, specificity of 97.6%, and negative predictive value of 75.9% Conclusion: High FIB-4 index and PSI score detected in the early period in patients admitted to the ICU due to COVID-19 seem to be predictors of in-hospital mortality. Keywords: Coronavirus infection, liver fibrosis, pneumonia, prognostic factors Amac: Yogun bakim unitesine (YBU) yatirilan, yeni siddetli akut solunum yolu sendromu koronavirus-2 enfeksiyonu nedeniyle yatirilan hastalarda erken donemde hesaplanan hepatik fibrozis-4 (FIB-4) indeks skorunun, pnomoni ciddiyet indeksi (PSI) ve hastane ici mortaliteyle iliskisinin arastirilmasi amaclandi. Gerec ve Yontem: Koronavirus hastaligi-2019 (COVID-19) tanisi konulan, hipoksemi nedeniyle YBU'ye yatirilan ve ardisik secilen 76 hasta dahil edildi. Burun ve bogaz suruntu orneklerinde gercek zamanli ters transkripsiyon- polimeraz zincir reaksiyonu (RT-PCR) kullanilarak COVID-19 enfeksiyonu tanisi konuldu. Daha once RT-PCR ile COVID- 19 tanisi almis hastalarin akciger bilgisayarli tomografi incelemelerinde tipik buzlu cam opasitelerinin ve subsegmental konsolidasyon alanlarinin gosterilmesiyle pnomoni tanisi dogrulandi. Hepatik FIB-4 indeks skoru ve PSI skoru her hasta icin ayri ayri hesaplandi, istatistiksel yontemde, nicel verileri karsilastirmak icin independent samples t-testi ve Mann-Whitney U testi kullanildi. Niteliksel verilerin karsilastirilmasi icin ki- kare testi kullanildi Bulgular: FIB-4 degeri ve PSI degeri, mortalite olmayan gruba gore mortalite grubunda onemli olcude daha yuksekti (p<0,05). Ayrica diger laboratuvar parametreleri acisindan da iki grup arasinda istatistiksel olarak anlamli fark yoktu (p>0,05) FIB-4 degeri mortalite olan ve olmayan hastalari ayirmada [egri altinda 0,835 (0,742-0,929)] anlamli olarak prediktifti. 5,4'luk bir esik degeri icin, FIB-4'un duyarliligi %60,6, pozitif ongoru degeri %95,2, ozgullugu %97,6 ve negatif prediktif degeri %75,9 olarak bulundu. Sonuc: COVID-19 nedeniyle, YBU'ye yatirilan hastalarda erken donemde saptanan yuksek FIB-4 indeksi ve PSI skoru hastane ici mortalitenin prediktorleri olarak gozukmektedir. Anahtar Kelimeler: Koronavirus enfeksiyonu, karaciger fibrozisi, pnomoni, prognostik faktorler