Published online Oct 7, 2022. doi: 10.3748/wjg.v28.i37.5444
Peer-review started: June 22, 2022
First decision: August 1, 2022
Revised: August 16, 2022
Accepted: September 13, 2022
Article in press: September 13, 2022
Published online: October 7, 2022
Processing time: 98 Days and 13.1 Hours
Metabolic associated fatty liver disease (MAFLD) is associated with complications and mortality in patients with coronavirus disease 2019 (COVID-19). However, there are no prognostic scores aimed to evaluate the risk of severe disease speci
To evaluate the prognostic performance of an index based on lactate dehydrogenase and transaminases (aspartate aminotransferase/alanine aminotransferase) in patients with COVID-19 and MAFLD [liver fibrosis and nutrition (LNF)-COVID-19 index].
In this retrospective cohort study, two cohorts from two different tertiary centers were included. The first was the derivation cohort to obtain the score cutoffs, and the second was the validation cohort. We included hospitalized patients with severe COVID-19 and MAFLD. Liver steatosis was evaluated by computed tomography scan. Area under the receiver operating characteristic (ROC) curve analysis and survival analysis were used.
In the derivation cohort, 44.6% had MAFLD; ROC curve analysis yielded a LFN-COVID-19 index > 1.67 as the best cutoff, with a sensitivity of 78%, specificity of 63%, negative predictive value of 91% and an area under the ROC curve of 0.77. In the multivariate analysis, the LFN-COVID-19 index > 1.67 was independently associated with the development of acute kidney injury (odds ratio: 1.8, 95% confidence interval: 1.3-2.5, P < 0.001), orotracheal intubation (odds ratio: 1.9, 95% confidence interval: 1.4-2.4, P < 0.001), and death (odds ratio: 2.86, 95% confidence interval: 1.6-4.5, P < 0.001) in both cohorts.
LFN-COVID-19 index has a good performance to predict prognosis in patients with MAFLD and COVID-19, which could be useful for the MAFLD population.
Core Tip: The liver fibrosis and nutrition-coronavirus disease 2019 (LFN-COVID-19) index that includes lactate dehydrogenase and transaminases is a new prognostic index for patients with metabolic associated fatty liver disease and COVID-19; it was developed to specifically predict adverse clinical outcomes, including mortality, in this population with both conditions. The variables included in this index allow an easy, quick and reliable risk assessment in this population with simple markers, allowing for broad implementation.