tetano
Editor, Senior Moderator
J Clin Med
. 2024 Sep 27;13(19):5777.
doi: 10.3390/jcm13195777. The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients
José Manuel Reyes-Ruiz[SUP] 1 [/SUP], Ana Citlali Avelino-Santiago[SUP] 1 [/SUP], Gustavo Martínez-Mier[SUP] 1 [/SUP], Claudia Vanessa López-López[SUP] 2 3 [/SUP], Luis Adrián De Jesús-González[SUP] 4 [/SUP], Moises León-Juárez[SUP] 5 [/SUP], Juan Fidel Osuna-Ramos[SUP] 6 [/SUP], Carlos Noe Farfan-Morales[SUP] 7 8 [/SUP], Selvin Noé Palacios-Rápalo[SUP] 9 [/SUP], Víctor Bernal-Dolores[SUP] 1 [/SUP], Rosa María Del Ángel[SUP] 8 [/SUP]
Affiliations
Background/Objectives: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. Methods: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (n = 139) and non-survivors (n = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. Results: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; p = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio
= 1.83; 95% confidence interval [CI]: 1.2-2.8; P[SUB]corrected[/SUB] = 0.03) was an independent predictor for mortality of COVID-19. Conclusions: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.
Keywords: COVID-19; SARS-CoV-2; biomarker; model for end-stage liver disease (MELD) score; mortality.
. 2024 Sep 27;13(19):5777.
doi: 10.3390/jcm13195777. The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients
José Manuel Reyes-Ruiz[SUP] 1 [/SUP], Ana Citlali Avelino-Santiago[SUP] 1 [/SUP], Gustavo Martínez-Mier[SUP] 1 [/SUP], Claudia Vanessa López-López[SUP] 2 3 [/SUP], Luis Adrián De Jesús-González[SUP] 4 [/SUP], Moises León-Juárez[SUP] 5 [/SUP], Juan Fidel Osuna-Ramos[SUP] 6 [/SUP], Carlos Noe Farfan-Morales[SUP] 7 8 [/SUP], Selvin Noé Palacios-Rápalo[SUP] 9 [/SUP], Víctor Bernal-Dolores[SUP] 1 [/SUP], Rosa María Del Ángel[SUP] 8 [/SUP]
Affiliations
- PMID: 39407839
- DOI: 10.3390/jcm13195777
Background/Objectives: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. Methods: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (n = 139) and non-survivors (n = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. Results: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; p = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio
= 1.83; 95% confidence interval [CI]: 1.2-2.8; P[SUB]corrected[/SUB] = 0.03) was an independent predictor for mortality of COVID-19. Conclusions: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.
Keywords: COVID-19; SARS-CoV-2; biomarker; model for end-stage liver disease (MELD) score; mortality.