Research Article
Prevalence and Prognostic Importance of High Fibrosis-4 Index in COVID-19 Patients
Table 1
Baseline demographics, clinical findings, and laboratory test data categorized according to the FIB-4 index at diagnosis.
| | | Total (n = 619) | FIB-4 <1.3 n = 270 (43.6%) | FIB-4 1.3–2.67 n = 262 (42.3%) | FIB-4 >2.67 n = 87 (14.1%) | |
| | Gender n (%) | Male | 363 (58.6) | 146 (54.1) | 156 (59.5) | 61 (70.1) | 0.028 | | Female | 256 (41.4) | 124 (45.9) | 106 (40.5) | 26 (29.9) | |
| | Age (years) median (IQR) | 52 (45–58) | 49 (43–55) | 53 (47–59) | 55 (50–61) | <0.001 |
| | Comorbidities n (%) | Diabetes mellitus | 153 (24.7) | 62 (23.0) | 65 (24.8) | 26 (29.9) | 0.428 | | Hypertension | 206 (33.3) | 80 (29.6) | 99 (37.9) | 27 (31.0) | 0.113 | | Ischemic heart disease | 39 (6.4) | 10 (3.7) | 20 (7.8) | 9 (10.3) | 0.044 | | Heart failure | 12 (2.0) | 2 (0.7) | 8 (3.1) | 2 (2.3) | 0.145 | | Chronic kidney disease | 16 (2.6) | 6 (2.2) | 8 (3.1) | 2 (2.3) | 0.821 | | COPD | 27 (4.4) | 9 (3.4) | 16 (6.2) | 2 (2.3) | 0.175 | | Active malignancy | 12 (2.0) | 0 (0.0) | 7 (2.7) | 5 (5.7) | <0.001 | | Collagenous/autoimmune disease | 25 (4.1) | 14 (5.2) | 8 (3.1) | 3 (3.4) | 0.436 | | Cerebrovascular/neurological disease | 11 (1.8) | 4 (1.5) | 5 (1.9) | 2 (2.3) | 0.773 | | Cardio-cerebrovascular disease | 49 (8.0) | 14 (5.2) | 24 (9.2) | 11 (12.6) | 0.051 |
| | Time between first symptom and diagnosis (days) median (IQR) | 4.5 (3–7) | 5 (3–7) | 5 (3–7) | 4 (2–6.75) | 0.174 |
| | Symptoms on admission n (%) | Fever | 290 (47.0) | 119 (44.2) | 127 (48.5) | 44 (51.2) | | | Fatigue | 292 (47.5) | 123 (45.6) | 123 (47.3) | 46 (54.1) | 0.386 | | Shortness of breath | 196 (31.7) | 74 (27.4) | 98 (37.4) | 24 (27.6) | 0.031 | | Dry cough | 374 (60.4) | 156 (57.8) | 170 (64.9) | 48 (55.2) | 0.137 | | Cough with phlegm | 41 (6.6) | 15 (5.6) | 20 (7.6) | 6 (6.9) | 0.625 | | Anorexia | 27 (4.4) | 9 (3.3) | 10 (3.8) | 8 (9.2) | 0.057 | | Muscle pain | 143 (23.1) | 65 (24.1) | 61 (23.3) | 17 (19.5) | 0.681 | | Throat ache | 85 (13.7) | 40 (14.8) | 33 (12.6) | 12 (13.8) | 0.758 | | Headache | 94 (15.2) | 40 (14.8) | 37 (14.1) | 17 (19.5) | 0.463 | | Diarrhoea | 50 (8.1) | 24 (8.9) | 19 (7.3) | 7 (8.0) | 0.787 | | Anosmia | 30 (4.8) | 12 (4.4) | 14 (5.3) | 4 (4.6) | 0.884 |
| | COVID-19-related clinical status at time of diagnosis n (%) | Asymptomatic | 29 (4.7) | 17 (6.3) | 10 (3.8) | 2 (2.3) | 0.210 | | Asymptomatic or mild disease | 518 (83.7) | 234 (86.7) | 216 (82.4) | 68 (78.2) | 0.135 | | Moderate-to-severe disease | 101 (16.3) | 36 (13.3) | 46 (17.6) | 19 (21.8) | |
| | Laboratory findings at time of diagnosis median (IQR) | Haemoglobin (g/dl) | 13.3 (12.1–14.3) | 13.3 (12.1–14.3) | 13.3 (12.3–14.3) | 13.1 (11.8–14.4) | 0.367 | | Neutrophil count (/mm3) | 3550 (2600–5000) | 4205 (3007.5–5622.5) | 3290 (2430–4832.5) | 2830 (2200–3950) | <0.001 | | Lymphocyte count (/mm3) | 1360 (960–1860) | 1635 (1197.5–2100) | 1240 (860–1610) | 1090 (770–1440) | <0.001 | | Platelet count (×1000/mm3) | 200 (155–253) | 251 (206.75–307.75) | 178.5 (149–215) | 120 (100–145) | <0.001 | | Erythrocyte sedimentation rate (mm/hr) | 36 (16–59) | 33 (12–54) | 40 (19–61) | 37.5 (18–45.5) | 0.043 | | Creatinine (mg/dL) | 0.84 (0.7–0.99) | 0.82 (0.67–0.98) | 0.85 (0.7–0.99) | 0.865 (0.73–1.09) | 0.017 | | eGFR median (IQR) | 110.4 (82.8–152.4) | 116.8 (90.0–159.8) | 108.5 (81.7–148.6) | 98.7 (66.9–138.2) | 0.002 | | Albumin (g/dl) | 3.8 (3.4–4.1) | 3.8 (3.5–4.1) | 3.7 (3.4–4) | 3.6 (3.35–3.9) | 0.008 | | AST (IU/L) | 28 (22–40) | 23 (18–30) | 31 (24.75–42.25) | 50 (34–76) | <0.001 | | ALT (IU/L) | 27 (19–41) | 27 (18–40) | 27 (19–41.25) | 31 (21–56) | 0.047 | | LDH (IU/L) | 312 (237–423.75) | 285 (214.5–383) | 311.5 (243–427.25) | 398 (315–535) | <0.001 | | CK (IU/L) | 88 (57.75–175.5) | 72 (52–109.5) | 99 (61.5–187) | 205.5 (89.75–507.25) | <0.001 | | Amylase (IU/L)) | 59 (47–80) | 57 (45–74) | 58.5 (48–82) | 73 (47.5–91.5) | 0.062 | | Lipase (IU/L) | 34.7 (21.3–54.2) | 31 (20–46) | 35 (22.6–57.5) | 39 (24.5–66) | 0.046 | | Ferritin (ng/ml) | 200 (109–441) | 166 (83–317.25) | 228 (126.5–483.5) | 330.1 (166.75–749.4) | <0.001 | | Lymphopenia n (%) | 242 (39.1) | 67 (24.8) | 124 (47.3) | 51 (58.6) | <0.001 | | CRP n (%) | Normal | 87 (14.1) | 62 (23.0) | 21 (8.0) | 4 (4.6) | <0.001 | | 1–5 times increase | 208 (33.6) | 91 (33.7) | 94 (35.9) | 23 (26.4) | | 5–10 times increase | 124 (20.0) | 49 (18.1) | 58 (22.1) | 17 (19.5) | | 10–20 times increase | 106 (17.1) | 38 (14.1) | 45 (17.2) | 23 (26.4) | | >20 times increase | 94 (15.2) | 30 (11.1) | 44 (16.8) | 20 (23.0) |
| | Procalcitonin at diagnosis n (%) | Normal | 453 (83.9) | 209 (90.1) | 188 (82.1) | 56 (70.9) | <0.001 | | High | 87 (16.1) | 23 (9.9) | 41 (17.9) | 23 (29.1) |
| | D-dimer n (%) | Normal | 339 (57.5) | 172 (66.7) | 127 (51.6) | 40 (46.5) | <0.001 | | 1––<3 times | 162 (27.5) | 53 (20.5) | 87 (35.4) | 22 (25.6) | | >3 times | 89 (15.1) | 33 (12.8) | 32 (13.0) | 24 (27.9) |
| | CT imaging n (%) | | 611 (98.9) | 266 (98.5) | 260 (99.2) | 85 (98.8) | 0.776 |
| | CT findings n (%) | Single lesion | 20 (3.3) | 8 (3.0) | 5 (1.9) | 7 (8.2) | <0.001 | | Unilateral multiple lesion | 43 (7.1) | 30 (11.4) | 11 (4.3) | 2 (2.4) | | Bilateral multiple lesion | 515 (84.8) | 209 (79.2) | 233 (90.3) | 73 (85.9) | | Completely normal | 29 (4.8) | 17 (6.4) | 9 (3.5) | 3 (3.5) |
| | Diagnosis-follow-up duration days median (IQR) | 8 (5–12) | 7 (5–10) | 8 (6–13) | 11 (8–12) | <0.001 | | ICU admission n (%) | | 37 (6.0) | 11 (4.1) | 19 (7.3) | 7 (8.0) | 0.206 | | Intubation n (%) | | 15 (44.1) | 6 (60.0) | 5 (29.4) | 4 (57.1) | 0.261 |
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ALT, alanine aminotransferase; AST, aspartate aminotransferase; CK creatinine kinase; COPD, chronic obstructive pulmonary disease; CRP, C-reactive protein; CT, computerised thorax tomography; FIB-4, fibrosis index; eGFR, estimated glomerular filtration rate; GGT,-glutamyl transpeptidase; ICU, intensive care unit; INR, international normalized rate; LDH, lactate dehydrogenase.
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