Fibrosis-4 index and mortality in coronavirus disease 2019: a meta-analysis

Autor: Emir Yonas, Sally Aman Nasution, Michael Anthonius Lim, Raymond Pranata, Ian Huang, Raden Ayu Tuty Kuswardhani
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: European Journal of Gastroenterology & Hepatology
ISSN: 1473-5687
0954-691X
Popis: Background/aims In this meta-analysis, we aimed to evaluate the prognostic value of fibrosis-4 index (FIB-4) in COVID-19. Methods We performed a comprehensive literature search of PubMed, Embase, and Scopus databases on 26 November 2020. FIB-4 was calculated by [age (years) × AST (IU/L)]/[platelet count (109/L) × √ALT (U/L)]. A value above cutoff point was considered high and a value below cutoff point was considered low. The main outcome was mortality, the association between high FIB-4 and mortality was reported in odds ratio (OR). Sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic OR (DOR), area under the curve (AUC) were generated. Results There were 963 patients from five studies included in this systematic review and meta-analysis. Meta-analysis showed that high FIB-4 was associated with increased mortality [OR 3.96 (2.16–7.27), P < 0.001; I2: 41.3%]. High FIB-4 was associated mortality with a sensitivity of 0.56 (0.40–0.70), specificity of 0.80 (0.72–0.86), PLR 2.8 (1.8–4.2), NLR 0.55 (0.39–0.78), DOR 5 (2–10), and AUC of 0.77 (0.73–0.81). Fagan’s nomogram indicated that for a pre-test probability (mortality) of 30%, a high FIB-4 was associated with 54% post-test probability and a low FIB-4 was associated with 19%, respectively. The funnel-plot analysis was asymmetrical, trim-and-fill analysis by imputation of a study on the left side using linear estimator resulted in an OR of 3.48 (1.97–6.14). Egger’s test showed no indication of small-study effects (P = 0.881). Conclusion High FIB-4 was associated with mortality in patients with COVID-19.
Databáze: OpenAIRE
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