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

Abstract

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.