Impact of liver fibrosis on COVID-19 in-hospital mortality in Southern Italy

被引：2

作者：

Galiero, Raffaele ^{[1
]}

Loffredo, Giuseppe ^{[1
]}

Simeon, Vittorio ^{[2
]}

Caturano, Alfredo ^{[1
]}

Vetrano, Erica ^{[1
]}

Medicamento, Giulia ^{[1
]}

Alfano, Maria ^{[1
]}

Beccia, Domenico ^{[1
]}

Brin, Chiara ^{[1
]}

Colantuoni, Sara ^{[1
]}

Di Salvo, Jessica ^{[1
]}

Epifani, Raffaella ^{[1
]}

Nevola, Riccardo ^{[1
,3
]}

Marfella, Raffaele ^{[1
]}

Sardu, Celestino ^{[1
]}

Coppola, Carmine ^{[4
]}

Scarano, Ferdinando ^{[5
]}

Maggi, Paolo ^{[6
]}

Calabrese, Cecilia ^{[7
]}

De Lucia Sposito, Pellegrino ^{[8
]}

Rescigno, Carolina ^{[9
]}

Sbreglia, Costanza ^{[10
]}

Fraganza, Fiorentino ^{[11
]}

Parrella, Roberto ^{[12
]}

Romano, Annamaria ^{[13
]}

Calabria, Giosuele ^{[14
]}

Polverino, Benedetto ^{[15
]}

Pagano, Antonio ^{[16
]}

Numis, Fabio ^{[16
]}

Bologna, Carolina ^{[17
]}

Nunziata, Mariagrazia ^{[18
]}

Esposito, Vincenzo ^{[19
]}

Coppola, Nicola ^{[20
]}

Maturo, Nicola ^{[21
]}

Nasti, Rodolfo ^{[22
]}

Di Micco, Pierpaolo ^{[23
]}

Perrella, Alessandro ^{[24
]}

Adinolfi, Luigi Elio ^{[1
]}

Chiodini, Paolo ^{[2
]}

Di Domenico, Marina ^{[25
]}

Rinaldi, Luca ^{[1
]}

Sasso, Ferdinando Carlo ^{[1
]}

机构：

[1] Univ Campania Luigi Vanvitelli, Dept Adv Med & Surg Sci, Naples, Italy

[2] Univ Campania Luigi Vanvitelli, Dept Phys & Mental Hlth & Prevent Med, Med Stat Unit, Naples, Italy

[3] Osped Evangelico Betania, Naples, Italy

[4] Area Stabiese Hosp, Hepatol Unit, Internal Med, Naples, Italy

[5] S Anna & SS Madonna della Neve Hosp, COVID Ctr, Boscotrecase, Italy

[6] S Anna & S Sebastiano Hosp, UOC Infect & Trop Dis, Caserta, Italy

[7] Univ Campania Luigi Vanvitelli, Pneumol Vanvitelli Dept Translat Med Sci, Naples, Italy

[8] Maddaloni Hosp, Covid Ctr, Maddaloni, Italy

[9] Cotugno Hosp, UOC Infect Dis & Neurol, Naples, Italy

[10] Cotugno Hosp, UOC Infect Dis Elderly, Naples, Italy

[11] Cotugno Hosp, UOC Anestesia & Intens Care Unit, Naples, Italy

[12] Cotugno Hosp, UOC Resp Infect Dis, Naples, Italy

[13] Moscati Hosp, UOC Pneumol, Avellino, Italy

[14] Cotugno Hosp, Div Infect Dis & Intervent Ultrasound 9, Naples, Italy

[15] Giovanni da Procida Hosp, Salerno, Italy

[16] Santa Maria delle Grazie Hosp, Emergency & Acceptance Unit, Pozzuoli, Italy

[17] Osped Del Mare, Internal Med Unit, Naples, Italy

[18] Moscati Hosp, UOC Internal Med, Avellino, Italy

[19] Cotugno Hosp, Div Immunodeficiency & Gender Infect Dis 4, Naples, Italy

[20] Ctr COVID AOU Vanvitelli, Dept Mental Hlth & Publ Med, Naples, Italy

[21] Cotugno Hosp, UOSD Infect Dis Emergency & Acceptance, Naples, Italy

[22] Emergency Div, AORN Antonio Cardarelli, Naples, Italy

[23] Fatebenefratelli Hosp Naples, Dept Internal Med, Naples, Italy

[24] Task Force COVID 19 Reg Campania, Naples, Italy

[25] Univ Campania Luigi Vanvitelli, Dept Precis Med, Naples, Italy

来源：

PLOS ONE | 2024年 / 19卷 / 05期

关键词：

CORONAVIRUS DISEASE 2019; GENERAL-POPULATION; INDEX; PREVALENCE; INFECTION; OUTCOMES; TESTS;

D O I：

10.1371/journal.pone.0296495

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background & aims SARS-Cov-2 infection manifests as a wide spectrum of clinical presentation and even now, despite the global spread of the vaccine, contagiousness is still elevated. The aim of the study was the evaluation of the impact of liver fibrosis assessed by FIB-4 and liver impairment, assessed by cytolysis indices, on intrahospital mortality in COVID-19 subjects. Methods This is a retrospective observational cohort study, which involved 23 COVID Hospital Units in Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. According to FIB-4 values, we subdivided the overall population in three groups (FIB-4<1.45; 1.453.25), respectively group 1,2,3. Results At the end of the study, 938 individuals had complete discharged/dead data. At admission, 428 patients were in group 1 (45.6%), 387 in group 2 (41.3%) and 123 in group 3 (13.1%). Among them, 758 (81%) subjects were discharged, while the remaining 180 (19%) individuals died. Multivariable Cox's regression model showed a significant association between mortality risk and severity of FIB-4 stages (group 3 vs group 1, HR 2.12, 95%CI 1.38-3.28, p<0.001). Moreover, Kaplan-Meier analysis described a progressive and statistically significant difference (p<0.001 Log-rank test) in mortality according to FIB-4 groups. Among discharged subjects, 507 showed a FIB-4<1.45 (66.9%, group 1), 182 a value 1.453.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.453.25 (42.3%, group 3). Conclusions FIB-4 value is significantly associated with intrahospital mortality of COVID-19 patients. During hospitalization, particularly in patients with worse outcomes, COVID-19 seems to increase the risk of acute progression of liver damage.

引用

页数：18

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