Madian A, Eliwa A, Abdalla H, A Azeem Aly H. Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19. World J Gastroenterol 2022; 28(16): 1671-1680 [PMID: 35581967 DOI: 10.3748/wjg.v28.i16.1671]
Corresponding Author of This Article
Ali Madian, MD, MSc, Lecturer, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt. a.madian@azhar.edu.eg
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 28, 2022; 28(16): 1671-1680 Published online Apr 28, 2022. doi: 10.3748/wjg.v28.i16.1671
Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19
Ali Madian, Ahmed Eliwa, Hytham Abdalla, Haitham A Azeem Aly
Ali Madian, Haitham A Azeem Aly, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Ahmed Eliwa, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Cairo, Cairo 11754, Egypt
Hytham Abdalla, Department of Chest Diseases, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt
Author contributions: Madian A was responsible for the study conception and design, the data acquisition, analysis and interpretation, the statistical analysis, and writing of the first draft of the manuscript; Eliwa A and Abdalla H contributed to the data collection; Azeem HA reviewed the manuscript and provided critical scientific input; all authors approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
Informed consent statement: No informed consent was required, as patient identity is not revealed in the retrospective analysis.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at a.madian@azhar.edu.eg.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ali Madian, MD, MSc, Lecturer, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University-Assiut, Assiut 71524, Egypt. a.madian@azhar.edu.eg
Received: November 16, 2021 Peer-review started: November 16, 2021 First decision: January 11, 2022 Revised: January 21, 2022 Accepted: March 16, 2022 Article in press: March 16, 2022 Published online: April 28, 2022 Processing time: 158 Days and 16.7 Hours
ARTICLE HIGHLIGHTS
Research background
Coronavirus disease 2019 (COVID-19) has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.
Research motivation
Development of a prediction model using objective, inexpensive, and readily available items is needed for patients with COVID-19.
Research objectives
To investigate whether the aspartate transferase-to-platelet ratio index (APRI) is associated with all-cause in-hospital mortality among patients with COVID-19 and develop a predictive model using objective and readily available factors.
Research methods
A retrospective cohort study was carried out with 353 consecutive adult patients admitted to Al-Azhar University Hospital (Assiut, Egypt) and Chest Hospital (Assiut, Egypt) with confirmed COVID-19 from July 1, 2020 to October 1, 2020.
Research results
The prediction model comprised APRI alone (APRI model), and the area under the receiver operating curve (AUROC) for the prediction of mortality was 0.66 [95% confidence interval (CI): 0.56-0.76]. A modified model of APRI that included age and serum ferritin (APRI-plus model) had better accuracy than the APRI model, as the AUROC became 0.90 (95%CI: 0.86-0.95) (P < 0.0001).
Research conclusions
APRI-plus among patients with COVID-19 showed good performance in predicting mortality. A prediction model could help stratify the risk of mortality.
Research perspectives
Further studies are required to investigate this association. Validation of the APRI-plus is required.
