Abstract

Objective: To evaluate the predictive value of the fibrosis-4 (FIB-4) index for mortality among patients with Coronavirus disease-2019 (COVID-19).

Methods: This retrospective study included 325 patients diagnosed with COVID-19 via reverse transcription-polymerase chain reaction at a tertiary care hospital from January 2021 to January 2022. We calculated the FIB-4 index using age, aspartate aminotransferase, alanine aminotransferase, and platelet count. Data on demographics, clinical characteristics, comorbid conditions, and outcomes were analyzed.

Results: Patients were categorized into survivors (56.6%, n=184) and non-survivors (43.4%, n=151). The median FIB-4 index was significantly higher in non-survivors [4.02 interquartile range (IQR) 2.48-8.62)] than in survivors [2.57 (IQR 1.69-3.95)], p<0.001. ROC analysis showed that the FIB-4 index had a moderate predictive accuracy for mortality (area under the curve =0.693). A FIB-4 index cut-off of >3.80 provided the best balance between sensitivity (53.90%) and specificity (74.46%).

Conclusion: The FIB-4 index serves as a reliable predictor of mortality in patients with COVID-19, surpassing traditional liver function tests in prognostic accuracy. It offers a practical tool for the early identification of patients at higher risk of adverse outcomes.