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

Copyright: © 2024 Galiero et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited..

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; 1.45<FIB-4<3.25; FIB-4>3.25), 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 1.45<FIB-4<3.25 (24.1%, group 2) and 69 a FIB-4>3.25 (9.0%, group 3). Among dead subjects, 42 showed a FIB-4<1.45 (23.3%, group 1), 62 a value 1.45<FIB-4<3.25 (34.4%, group 2) and 76 a FIB-4>3.25 (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.

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Electronic Article

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To Main Record - volume:19

Contained In:

PloS one - 19(2024), 5 vom: 01., Seite e0296495




Galiero, Raffaele [Author]
Loffredo, Giuseppe [Author]
Simeon, Vittorio [Author]
Caturano, Alfredo [Author]
Vetrano, Erica [Author]
Medicamento, Giulia [Author]
Alfano, Maria [Author]
Beccia, Domenico [Author]
Brin, Chiara [Author]
Colantuoni, Sara [Author]
Di Salvo, Jessica [Author]
Epifani, Raffaella [Author]
Nevola, Riccardo [Author]
Marfella, Raffaele [Author]
Sardu, Celestino [Author]
Coppola, Carmine [Author]
Scarano, Ferdinando [Author]
Maggi, Paolo [Author]
Calabrese, Cecilia [Author]
De Lucia Sposito, Pellegrino [Author]
Rescigno, Carolina [Author]
Sbreglia, Costanza [Author]
Fraganza, Fiorentino [Author]
Parrella, Roberto [Author]
Romano, Annamaria [Author]
Calabria, Giosuele [Author]
Polverino, Benedetto [Author]
Pagano, Antonio [Author]
Numis, Fabio [Author]
Bologna, Carolina [Author]
Nunziata, Mariagrazia [Author]
Esposito, Vincenzo [Author]
Coppola, Nicola [Author]
Maturo, Nicola [Author]
Nasti, Rodolfo [Author]
Di Micco, Pierpaolo [Author]
Perrella, Alessandro [Author]
Adinolfi, Luigi Elio [Author]
Chiodini, Paolo [Author]
Di Domenico, Marina [Author]
Rinaldi, Luca [Author]
Sasso, Ferdinando Carlo [Author]
COVOCA Study Group [Author]




Journal Article
Observational Study


Date Completed 07.05.2024

Date Revised 07.06.2024

published: Electronic-eCollection

Citation Status MEDLINE




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