The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Clinical Examination and Laboratory Tests
2.3. Liver Steatosis and Fibrosis Assessment
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Enrolled Patients
3.2. Differences between Patients Stratified by Fibrosis Status
3.3. Factors Associated with Poor Prognosis in NAFLD Population
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Male gender (%) | 57.2% (79) |
Age | 66.32 ± 13.72 |
BMI | 29.91 ± 5.28 |
COMORBIDITIES | |
Cardiovascular diseases | 5.80% |
Hypertension | 46.20% |
Obesity | 48.50% |
Dyslipidemia | 10.20% |
Pulmonary disease | 3.80% |
Neurologic Disease | 4.10% |
Kidney Diseases | 1.40% |
Smoking | 32.30% |
SYMPTOMS AT PRESENTATIONS | |
Symptoms before presentation (days) | 5 (3–9) |
Headache | 37.2% |
Dyspnea | 58.2% |
Fever | 31.2% |
Cough | 69.3% |
Chest pain | 22.4% |
Abdominal pain | 10.2% |
Diarrhea | 34.9% |
Nausea | 13.1% |
Vomiting | 5.2% |
Anosmia | 6.8% |
Dysgeusia | 4.7% |
CLINICAL EXAMINATION AT PRESENTATION | |
Systolic BP (mmHg) | 126 (111–149) |
Heart Rate (bpm) | 94 (84–108) |
Saturation (%) | 88 (82–91) |
Respiratory Rate (rpm) | 24 (22–28) |
HOSPITAL EVOLUTION | |
Non-severe form of COVID-19 (%) | 36.3% (50) |
Severe form of COVID-19 (%) | 63.7% (88) |
Hospital stay (days) | 16 (11–22) |
ICU admission (%) | 44.9% (62) |
Deaths (%) | 18.1% (25) |
LABORATORY TESTS | |
Leukocytes (cell × 103 U/L) | 8.2 (6.3–11.11) |
Lymphocytes (%) | 9.7 (6.3–11.2) |
Platelets (cell × 103 U/L) | 186.2 (123.4–224.5) |
C-reactive protein (mg/dl) | 37.1 ± 2.33 |
Ferritin (ng/mL) | 677.4 ± 221.3 |
Total cholesterol (mg/dL) | 144.55 ± 49.29 |
Serum glucose (mg/dL) | 179.35 ± 85.2 |
HbA1C (%) | 6.76 ± 1.12 |
LIVER STEATOSIS AND FIBROSIS ASSESSMENT | |
Liver steatosis (NAFLD) | 91.3% (126) |
FIB-4 < 1.30 | 62.7% (79) |
FIB-4 1.30–3.25 | 15.8% (20) |
FIB-4 > 3.25 | 21.5% (27) |
AST (U/L) | 68.47 (49.2–80.7) |
ALT(U/L) | 58.7 (42.4–73.6) |
GGT (U/L) | 87.2 (39.7–109.3) |
ALP (U/L) | 77.9 (53.4–93.4) |
LDH (U/L) | 325 (248–384) |
Total bilirubin (mg/dL) | 1.2 (0.84–1.3) |
Direct bilirubin (mg/dL) | 0.4 (0.26–0.53) |
Albumin (g/dL) | 3.2 (2.9–3.7) |
FIB-4 < 1.3 (79) | FIB-4 1.3–3.25 (20) | FIB-4 > 3.25 (27) | p Value * | |
---|---|---|---|---|
Age (years) | 61.3 ± 10.5 | 64.25 ± 11.21 | 68.5 ± 12.2 | <0.001 |
BMI | 27.2 ± 4.5 | 27.9 ± 5.2 | 31.3 ± 5.6 | <0.001 |
Symptoms before presentation | 6 (3–9) | 6 (3–9) | 4 (2–6) | 0.034 |
Lymphocytes (%) | 9.5% | 8.70% | 8.3% | 0.095 |
C-reactive protein (mg/dL) | 37.76 ± 4.56 | 37.23 ± 4.89 | 38.45 ± 3.45 | 0.243 |
Ferritin (ng/dL) | 623.45 ± 198.56 | 625.87 ± 201.24 | 690.57 ± 197.85 | 0.013 |
Serum glucose (mg/dL) | 156.78 ± 65.24 | 164.54 ± 64.23 | 198.25 ± 87.68 | <0.001 |
HbA1C (%) | 7.1 (6.4–8.3) | 7.2 (6.6–8.4) | 7.8 (6.7–9.1) | 0.037 |
AST (U/L) | 44 (29–85) | 49 (36–75) | 57 (37–88) | <0.001 |
ALT (U/L) | 35 (26–58) | 37 (21–62) | 47 (29–76) | <0.001 |
GGT (U/L) | 69 (41–102) | 72 (45–99) | 94 (45–123) | <0.001 |
ALP (U/L) | 53 (31–81) | 62 (42–91) | 79 (49–98) | <0.001 |
LDH (U/L) | 317 (198–349) | 345 (215–357) | 391 (315–434) | 0.002 |
Total bilirubin (mg/dL) | 0.9 (0.6–1.1) | 0.8 (0.5–1.2) | 1.1 (0.7–1.5) | 0.067 |
Albumin (g/dL) | 3.8 (2.8–4.2) | 3.9 (3.0–4.5) | 3.7 (2.5–4.3) | 0.214 |
Total cholesterol (mmol/L) | 142.45 ± 47.25 | 140.57 ± 49.58 | 143.37 ± 48.56 | 0.458 |
Hospital stay (days) | 11 (7–15) | 13 (9–17) | 17 (12–21) | 0.014 |
ICU admission (%) | 8.7% (11) | 17.4% (22) | 23% (29) | 0.021 |
Severe form of COVID-19 (%) | 9.5% (12) | 21.4% (27) | 38.8% (49) | <0.001 |
Deaths (%) | 3.1% (4) | 6.3% (8) | 10.3% (13) | <0.001 |
Adjusted OR * (95% CI) | p Value ** | |
---|---|---|
Male gender (male vs. female) | 1.28 (0.92–3.53) | 0.587 |
Obesity (yes/no) | 3.24 (1.46–5.32) | 0.003 |
Dyspnea (yes/no) | 2.19 (1.56–6.29) | 0.042 |
C-reactive protein (every 10mg/L increment) | 0.56 (1.021–1.045) | 0.654 |
Ferritin (every 100 ng/mL increment) | 1.9 (1.78–8.29) | 0.031 |
AST (every 10 U/L increment) | 1.67 (0.94–1.03) | 0.087 |
ALT (every 10U/L increment) | 0.87 (0.99–1.09) | 0.354 |
FIB-4 < 1.3 | 1.25 (0.40–2.45) | 0.847 |
FIB-4 1.3–3.25 | 2.47 (1.01–7.63) | 0.057 |
FIB-4 > 3.25 | 4.89 (1.34–12.3) | 0.002 |
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Calapod, O.P.; Marin, A.M.; Onisai, M.; Tribus, L.C.; Pop, C.S.; Fierbinteanu-Braticevici, C. The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis. Medicina 2021, 57, 434. https://doi.org/10.3390/medicina57050434
Calapod OP, Marin AM, Onisai M, Tribus LC, Pop CS, Fierbinteanu-Braticevici C. The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis. Medicina. 2021; 57(5):434. https://doi.org/10.3390/medicina57050434
Chicago/Turabian StyleCalapod, Ovidiu P., Andreea M. Marin, Minodora Onisai, Laura C. Tribus, Corina S. Pop, and Carmen Fierbinteanu-Braticevici. 2021. "The Impact of Increased Fib-4 Score in Patients with Type II Diabetes Mellitus on COVID-19 Disease Prognosis" Medicina 57, no. 5: 434. https://doi.org/10.3390/medicina57050434