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High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study

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Author(s)
Sung-Woo KimJae-Han JeonJun Sung MoonMi Kyung Kim
Keimyung Author(s)
Kim, Mi Kyung
Department
Dept. of Internal Medicine (내과학)
Journal Title
Endocrinol Metab (Seoul)
Issued Date
2021
Volume
36
Issue
4
Keyword
Non-alcoholic fatty liver diseaseDiabetes mellitusCOVID-19Mortality
Abstract
Background:
Based on recent evidence on the importance of the presence of diabetes mellitus (DM) and fibrosis-4 (FIB-4) index in coronavirus disease 2019 (COVID-19) mortality, we analyzed whether these factors could additively predict such mortality.

Methods:
This multicenter observational study included 1,019 adult inpatients admitted to university hospitals in Daegu. The demographic and laboratory findings, mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM and/or a high FIB-4 index. The mortality risk and corresponding hazard ratio (HR) were analyzed using the Kaplan-Meier method and Cox proportional hazard models.

Results:
The patients with DM (n=217) exhibited significantly higher FIB-4 index and mortality compared to those without DM. Although DM (HR, 2.66; 95% confidence interval [CI], 1.63 to 4.33) and a high FIB-4 index (HR, 4.20; 95% CI, 2.21 to 7.99) were separately identified as risk factors for COVID-19 mortality, the patients with both DM and high FIB-4 index had a significantly higher mortality (HR, 9.54; 95% CI, 4.11 to 22.15). Higher FIB-4 indices were associated with higher mortality regardless of DM. A high FIB-4 index with DM was more significantly associated with a severe clinical course with mortality (odds ratio, 11.24; 95% CI, 5.90 to 21.41) than a low FIB-4 index without DM, followed by a high FIB-4 index alone and DM alone. The duration of quarantine and hospital stay also tended to be longer in those with both DM and high FIB-4 index.

Conclusion:
Both DM and high FIB-4 index are independent and additive risk factors for COVID-19 mortality.
Keimyung Author(s)(Kor)
김미경
Publisher
School of Medicine (의과대학)
Citation
Sung-Woo Kim et al. (2021). High Fibrosis-4 Index Is Related with Worse Clinical Outcome in Patients with Coronavirus Disease 2019 and Diabetes Mellitus: A Multicenter Observational Study. Endocrinol Metab (Seoul), 36(4), 800–809. doi: 10.3803/EnM.2021.1040
Type
Article
ISSN
2093-5978
Source
https://www.e-enm.org/journal/view.php?doi=10.3803/EnM.2021.1040
DOI
10.3803/EnM.2021.1040
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43939
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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