Fibrosis-4 index as a predictor for mortality in hospitalised patients with COVID-19: a retrospective multicentre cohort study

被引：30

作者：

Park, Jung Gil ^{[1
]}

Kang, Min Kyu ^{[1
]}

Lee, Yu Rim ^{[2
]}

Song, Jeong Eun ^{[3
]}

Kim, Na Young ^{[4
]}

Kweon, Young Oh ^{[2
]}

Tak, Won Young ^{[2
]}

Jang, Se Young ^{[2
]}

Lee, Changhyeong ^{[3
]}

Kim, Byung Seok ^{[3
]}

Hwang, Jae Seok ^{[4
]}

Jang, Byoung Kuk ^{[4
]}

Bae, Jinmok ^{[4
]}

Lee, Ji Yeon ^{[4
]}

Suh, Jeong Ill ^{[5
]}

Park, Soo Young ^{[2
]}

Chung, Woo Jin ^{[4
]}

机构：

[1] Yeungnam Univ, Coll Med, Dept Internal Med, Daegu, South Korea

[2] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Internal Med, Daegu, South Korea

[3] Daegu Catholic Univ, Sch Med, Dept Internal Med, Daegu, South Korea

[4] Keimyung Univ, Sch Med, Dept Internal Med, Daegu, South Korea

[5] Dongguk Univ, Gyeongju Hosp, Coll Med, Dept Internal Med, Gyeongju, South Korea

来源：

BMJ OPEN | 2020年 / 10卷 / 11期

关键词：

Coronavirus; COVID-19; risk factors; fibrosis; mortality; survival; PNEUMONIA; WUHAN;

D O I：

10.1136/bmjopen-2020-041989

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective The reliable risk factors for mortality of COVID-19 has not evaluated in well-characterised cohort. This study aimed to identify risk factors for in-hospital mortality within 56 days in patients with severe infection of COVID-19. Design Retrospective multicentre cohort study. Setting Five tertiary hospitals of Daegu, South Korea. Participants 1005 participants over 19 years old confirmed COVID-19 using real-time PCR from nasopharyngeal and oropharyngeal swabs. Methods The clinical and laboratory features of patients with COVID-19 receiving respiratory support were analysed to ascertain the risk factors for mortality using the Cox proportional hazards regression model. The relationship between overall survival and risk factors was analysed using the Kaplan-Meier method. Outcome In-hospital mortality for any reason within 56 days. Results Of the 1005 patients, 289 (28.8%) received respiratory support, and of these, 70 patients (24.2%) died. In multivariate analysis, high fibrosis-4 index (FIB-4; HR 2.784), low lymphocyte count (HR 0.480), diabetes (HR 1.917) and systemic inflammatory response syndrome (HR 1.714) were found to be independent risk factors for mortality in patients with COVID-19 receiving respiratory support (all p<0.05). Regardless of respiratory support, survival in the high FIB-4 group was significantly lower than in the low FIB-4 group (28.8 days vs 44.0 days, respectively, p<0.001). A number of risk factors were also significantly related to survival in patients with COVID-19 regardless of respiratory support (0-4 risk factors, 50.2 days; 49.7 days; 44.4 days; 32.0 days; 25.0 days, respectively, p<0.001). Conclusion FIB-4 index is a useful predictive marker for mortality in patients with COVID-19 regardless of its severity.

引用

页数：10

共 33 条

[1]

Bai X, 2020, 20037325 MEDRXIV, DOI [10.1101/2020.03.20.20037325, DOI 10.1101/2020.03.20.20037325]

[2]

Caramelo F., 2020, MEDRXIV, DOI [10.1101/2020.02.24.20027268, DOI 10.1101/2020.02.24.20027268]

[3] Clinical progression of patients with COVID-19 in Shanghai, China [J].

Chen, Jun ;

Qi, Tangkai ;

Liu, Li ;

Ling, Yun ;

Qian, Zhiping ;

Li, Tao ;

Li, Feng ;

Xu, Qingnian ;

Zhang, Yuyi ;

Xu, Shuibao ;

Song, Zhigang ;

Zeng, Yigang ;

Shen, Yinzhong ;

Shi, Yuxin ;

Zhu, Tongyu ;

Lu, Hongzhou .

JOURNAL OF INFECTION, 2020, 80 (05) :E1-E6

[4] Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study [J].

Chen, Nanshan ;

Zhou, Min ;

Dong, Xuan ;

Qu, Jieming ;

Gong, Fengyun ;

Han, Yang ;

Qiu, Yang ;

Wang, Jingli ;

Liu, Ying ;

Wei, Yuan ;

Xia, Jia'an ;

Yu, Ting ;

Zhang, Xinxin ;

Zhang, Li .

LANCET, 2020, 395 (10223) :507-513

[5] Clinical Features of COVID-19-Related Liver Functional Abnormality [J].

Fan, Zhenyu ;

Chen, Liping ;

Li, Jun ;

Cheng, Xin ;

Yang, Jingmao ;

Tian, Cheng ;

Zhang, Yajun ;

Huang, Shaoping ;

Liu, Zhanju ;

Cheng, Jilin .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2020, 18 (07) :1561-1566

[6] A Tool for Early Prediction of Severe Coronavirus Disease 2019 (COVID-19): A Multicenter Study Using the Risk Nomogram in Wuhan and Guangdong, China [J].

Gong, Jiao ;

Ou, Jingyi ;

Qiu, Xueping ;

Jie, Yusheng ;

Chen, Yaqiong ;

Yuan, Lianxiong ;

Cao, Jing ;

Tan, Mingkai ;

Xu, Wenxiong ;

Zheng, Fang ;

Shi, Yaling ;

Hu, Bo .

CLINICAL INFECTIOUS DISEASES, 2020, 71 (15) :833-840

[7] Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy [J].

Grasselli, Giacomo ;

Zangrillo, Alberto ;

Zanella, Alberto ;

Antonelli, Massimo ;

Cabrini, Luca ;

Castelli, Antonio ;

Cereda, Danilo ;

Coluccello, Antonio ;

Foti, Giuseppe ;

Fumagalli, Roberto ;

Iotti, Giorgio ;

Latronico, Nicola ;

Lorini, Luca ;

Merler, Stefano ;

Natalini, Giuseppe ;

Piatti, Alessandra ;

Ranieri, Marco Vito ;

Scandroglio, Anna Mara ;

Storti, Enrico ;

Cecconi, Maurizio ;

Pesenti, Antonio .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1574-1581

[8] Clinical Characteristics of Coronavirus Disease 2019 in China [J].

Guan, W. ;

Ni, Z. ;

Hu, Yu ;

Liang, W. ;

Ou, C. ;

He, J. ;

Liu, L. ;

Shan, H. ;

Lei, C. ;

Hui, D. S. C. ;

Du, B. ;

Li, L. ;

Zeng, G. ;

Yuen, K. -Y. ;

Chen, R. ;

Tang, C. ;

Wang, T. ;

Chen, P. ;

Xiang, J. ;

Li, S. ;

Wang, Jin-lin ;

Liang, Z. ;

Peng, Y. ;

Wei, L. ;

Liu, Y. ;

Hu, Ya-hua ;

Peng, P. ;

Wang, Jian-ming ;

Liu, J. ;

Chen, Z. ;

Li, G. ;

Zheng, Z. ;

Qiu, S. ;

Luo, J. ;

Ye, C. ;

Zhu, S. ;

Zhong, N. .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (18) :1708-1720

[9] Spread of SARS-CoV-2 in the Icelandic Population [J].

Gudbjartsson, Daniel F. ;

Helgason, Agnar ;

Jonsson, Hakon ;

Magnusson, Olafur T. ;

Melsted, Pall ;

Norddahl, Gudmundur L. ;

Saemundsdottir, Jona ;

Sigurdsson, Asgeir ;

Sulem, Patrick ;

Agustsdottir, Arna B. ;

Eiriksdottir, Berglind ;

Fridriksdottir, Run ;

Gardarsdottir, Elisabet E. ;

Georgsson, Gudmundur ;

Gretarsdottir, Olafia S. ;

Gudmundsson, Kjartan R. ;

Gunnarsdottir, Thora R. ;

Gylfason, Arnaldur ;

Holm, Hilma ;

Jensson, Brynjar O. ;

Jonasdottir, Aslaug ;

Jonsson, Frosti ;

Josefsdottir, Kamilla S. ;

Kristjansson, Thordur ;

Magnusdottir, Droplaug N. ;

le Roux, Louise ;

Sigmundsdottir, Gudrun ;

Sveinbjornsson, Gardar ;

Sveinsdottir, Kristin E. ;

Sveinsdottir, Maney ;

Thorarensen, Emil A. ;

Thorbjornsson, Bjarni ;

Loeve, Arthur ;

Masson, Gisli ;

Jonsdottir, Ingileif ;

Moeller, Alma D. ;

Gudnason, Thorolfur ;

Kristinsson, Karl G. ;

Thorsteinsdottir, Unnur ;

Stefansson, Kari .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (24) :2302-2315

[10] Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J].

Huang, Chaolin ;

Wang, Yeming ;

Li, Xingwang ;

Ren, Lili ;

Zhao, Jianping ;

Hu, Yi ;

Zhang, Li ;

Fan, Guohui ;

Xu, Jiuyang ;

Gu, Xiaoying ;

Cheng, Zhenshun ;

Yu, Ting ;

Xia, Jiaan ;

Wei, Yuan ;

Wu, Wenjuan ;

Xie, Xuelei ;

Yin, Wen ;

Li, Hui ;

Liu, Min ;

Xiao, Yan ;

Gao, Hong ;

Guo, Li ;

Xie, Jungang ;

Wang, Guangfa ;

Jiang, Rongmeng ;

Gao, Zhancheng ;

Jin, Qi ;

Wang, Jianwei ;

Cao, Bin .

LANCET, 2020, 395 (10223) :497-506

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