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. 2021 Sep 24;10(19):4355.
doi: 10.3390/jcm10194355.

FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Marko Zelenika  1 , Marko Lucijanic  2   3 , Tomislav Bokun  1   4 , Tonci Bozin  1 , Mislav Barisic Jaman  1 , Ida Tjesic Drinkovic  1 , Frane Pastrovic  1 , Anita Madir  3 , Ivica Luksic  3   5 , Nevenka Piskac Zivkovic  6 , Kresimir Luetic  7 , Zeljko Krznaric  3   8 , Rajko Ostojic  3   8 , Tajana Filipec Kanizaj  3   9 , Ivan Bogadi  9 , Lucija Virovic Jukic  3   10 , Michal Kukla  11 , Ivica Grgurevic  1   3   4
Affiliations

FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Marko Zelenika et al. J Clin Med. .

Abstract

Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19.

Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation.

Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome.

Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.

Keywords: COVID-19; liver; mortality; non-alcoholic steatohepatitis; transient elastography.

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Conflict of interest statement

Ivica Grgurevic received lecture fees from Echosens, Ferring and Gilead, travel support from Abbvie, and he served as an advisory board member for General Electric. The remaining authors have nothing to disclose.

Figures

Figure 1
Figure 1
Thirty-day mechanical ventilation or death rates stratified according to the FAST > 0.36. MV, mechanical ventilation; FAST, FibroScan-AST score.
See this image and copyright information in PMC

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