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Fibrosis-4 index and mortality in coronavirus disease 2019: a meta-analysis

Raymond Pranata1, Emir Yonas2, Ian Huang3

  • 1Faculty of Medicine, Universitas Pelita Harapan, Tangerang.

European Journal of Gastroenterology & Hepatology
|January 20, 2022
PubMed

Insights

The fibrosis-4 index (FIB-4) is a valuable predictor of mortality in COVID-19 patients. A high FIB-4 score indicates a significantly increased risk of death, aiding in patient risk stratification.

Area of Science:

  • Medical research
  • Prognostic biomarkers
  • Infectious disease epidemiology

Background:

  • The COVID-19 pandemic has highlighted the need for effective prognostic tools.
  • The fibrosis-4 index (FIB-4) is a non-invasive marker used to assess liver fibrosis.
  • Its potential prognostic value in COVID-19 patients requires thorough evaluation.

Purpose of the Study:

  • To systematically evaluate the prognostic significance of the fibrosis-4 index (FIB-4) in predicting mortality among COVID-19 patients.
  • To synthesize evidence from multiple studies through meta-analysis.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Embase, and Scopus databases.
  • FIB-4 was calculated using the formula: [age (years) × AST (IU/L)]/[platelet count (10^9/L) × √ALT (U/L)].
  • Meta-analysis was performed to determine the association between high FIB-4 and mortality, calculating odds ratios (OR), sensitivity, specificity, and AUC.

Main Results:

  • This meta-analysis included 963 patients from five studies.
  • High FIB-4 was significantly associated with increased COVID-19 mortality (OR 3.96; 95% CI: 2.16–7.27).
  • The diagnostic performance included a sensitivity of 0.56, specificity of 0.80, and AUC of 0.77, indicating moderate predictive capability.

Conclusions:

  • The fibrosis-4 index (FIB-4) is a significant independent predictor of mortality in COVID-19 patients.
  • Elevated FIB-4 levels can help identify patients at higher risk of adverse outcomes.
  • FIB-4 serves as a useful prognostic biomarker in the management of COVID-19.
Abstract

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