tetano
Editor, Senior Moderator
J Clin Med
. 2021 Sep 24;10(19):4355.
doi: 10.3390/jcm10194355.
FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19
Marko Zelenika[SUP] 1 [/SUP], Marko Lucijanic[SUP] 2 3 [/SUP], Tomislav Bokun[SUP] 1 4 [/SUP], Tonci Bozin[SUP] 1 [/SUP], Mislav Barisic Jaman[SUP] 1 [/SUP], Ida Tjesic Drinkovic[SUP] 1 [/SUP], Frane Pastrovic[SUP] 1 [/SUP], Anita Madir[SUP] 3 [/SUP], Ivica Luksic[SUP] 3 5 [/SUP], Nevenka Piskac Zivkovic[SUP] 6 [/SUP], Kresimir Luetic[SUP] 7 [/SUP], Zeljko Krznaric[SUP] 3 8 [/SUP], Rajko Ostojic[SUP] 3 8 [/SUP], Tajana Filipec Kanizaj[SUP] 3 9 [/SUP], Ivan Bogadi[SUP] 9 [/SUP], Lucija Virovic Jukic[SUP] 3 10 [/SUP], Michal Kukla[SUP] 11 [/SUP], Ivica Grgurevic[SUP] 1 3 4 [/SUP]
Affiliations
Abstract
Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19.
Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation.
Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome.
Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.
Keywords: COVID-19; liver; mortality; non-alcoholic steatohepatitis; transient elastography.
. 2021 Sep 24;10(19):4355.
doi: 10.3390/jcm10194355.
FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19
Marko Zelenika[SUP] 1 [/SUP], Marko Lucijanic[SUP] 2 3 [/SUP], Tomislav Bokun[SUP] 1 4 [/SUP], Tonci Bozin[SUP] 1 [/SUP], Mislav Barisic Jaman[SUP] 1 [/SUP], Ida Tjesic Drinkovic[SUP] 1 [/SUP], Frane Pastrovic[SUP] 1 [/SUP], Anita Madir[SUP] 3 [/SUP], Ivica Luksic[SUP] 3 5 [/SUP], Nevenka Piskac Zivkovic[SUP] 6 [/SUP], Kresimir Luetic[SUP] 7 [/SUP], Zeljko Krznaric[SUP] 3 8 [/SUP], Rajko Ostojic[SUP] 3 8 [/SUP], Tajana Filipec Kanizaj[SUP] 3 9 [/SUP], Ivan Bogadi[SUP] 9 [/SUP], Lucija Virovic Jukic[SUP] 3 10 [/SUP], Michal Kukla[SUP] 11 [/SUP], Ivica Grgurevic[SUP] 1 3 4 [/SUP]
Affiliations
- PMID: 34640373
- DOI: 10.3390/jcm10194355
Abstract
Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19.
Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation.
Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome.
Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.
Keywords: COVID-19; liver; mortality; non-alcoholic steatohepatitis; transient elastography.