Aminzadeh Anita, Azmi-Naei Nazanin, Teimouri Maryam, Rohani-Rasaf Marzieh
Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud 3614773955, Iran.
Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud 3614773955, Iran.
Diagnostics (Basel). 2025 Aug 8;15(16):1984. doi: 10.3390/diagnostics15161984.
Simple and cost-effective biochemical markers are still very useful for predicting severity and mortality in COVID-19 patients. This study investigates the association of some inflammatory and also non-invasive biochemical indices of liver function and critical care outcomes of COVID-19 patients. In this cross-sectional study, a total of 2232 hospitalized COVID-19 patients, regardless of the presence of underlying liver diseases, were followed. Based on the laboratory results at the time of admission, five indices-FIB-4 (Fibrosis-4), NLR (Neutrophil to Lymphocyte Ratio), APRI (Aspartate Aminotransferase to Platelet Ratio), ALRI (Aspartate Aminotransferase to Lymphocyte Ratio), and SII (Systemic Immune-Inflammation)-were calculated. According to the results of multivariate regression, all five indices were predictors of mortality and severity in COVID-19 patients after adjusting for age, sex, comorbidities and BMI. The odds ratios for FIB-4, NLR, APRI, ALRI, and SII to predict mortality were 1.14 (1.07-1.21), 1.07 (1.04-1.1), 1.28 (1.12-1.46), 2.44 (1.76-3.38), and 1.57 (1.13-2.17), respectively. For predicting severity, the odds ratios were 1.22 (1.15-1.30), 1.09 (1.06-1.11), 1.78 (1.44-2.21), 1.73 (1.41-2.14), and 1.27 (1.04-1.57), respectively. Additionally, based on the AUC results, FIB-4 and NLR indices demonstrated the best performance in predicting COVID-19 mortality and severity, respectively. Our results show that the non-invasive biochemical indices of liver function, NLR, and SII can be useful as early predictors of severity and mortality in COVID-19 patients.
简单且经济高效的生化标志物对于预测COVID-19患者的病情严重程度和死亡率仍然非常有用。本研究调查了COVID-19患者的一些炎症指标以及肝功能的非侵入性生化指标与重症监护结果之间的关联。在这项横断面研究中，共对2232名住院的COVID-19患者进行了随访，无论其是否存在潜在肝脏疾病。根据入院时的实验室检查结果，计算了五个指标——FIB-4（纤维化-4）、NLR（中性粒细胞与淋巴细胞比值）、APRI（天冬氨酸转氨酶与血小板比值）、ALRI（天冬氨酸转氨酶与淋巴细胞比值）和SII（全身免疫炎症指标）。根据多变量回归结果，在对年龄、性别、合并症和BMI进行调整后，所有这五个指标都是COVID-19患者死亡率和病情严重程度的预测指标。FIB-4、NLR、APRI、ALRI和SII预测死亡率的比值比分别为1.14（1.07-1.21）、1.07（1.04-1.1）、1.28（1.12-1.46）、2.44（1.76-3.38）和1.57（1.13-2.17）。对于预测病情严重程度，比值比分别为1.22（1.15-1.30）、1.09（1.06-1.11）、1.78（1.44-2.21）、1.73（1.41-2.14）和1.27（1.04-1.57）。此外，根据AUC结果，FIB-4和NLR指标在预测COVID-19死亡率和病情严重程度方面分别表现最佳。我们的结果表明，肝功能的非侵入性生化指标、NLR和SII可作为COVID-19患者病情严重程度和死亡率的早期预测指标。
