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Fib-4 Index Can Predict Mortality in Hospitalized Patients With Covid-19 Infection, Independent of Ct Severity Score Publisher Pubmed



Salahshour F1 ; Karimpour Reyhan S2 ; Zendedel K3 ; Seifouri K2 ; Seyyedsalehi MS3, 4 ; Naghavi P5 ; Abbaszadeh M2 ; Esteghamati A2 ; Nakhjavani M2 ; Rabizadeh S2
Authors
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Authors Affiliations
  1. 1. Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Medical and Surgical Sciences, University of Bologna, Bologna, 40138, Italy
  5. 5. Department of Information Engineering, University of Padua, Padua, Italy

Source: Archives of Iranian medicine Published:2025


Abstract

BACKGROUND: The fibrosis 4 (FIB-4) index is typically used in assessing liver fibrosis, and has shown potential in predicting the outcome in various diseases. This study aims to evaluate the predictive power of the FIB-4 index for mortality in COVID-19 patients admitted to a reference hospital in Tehran, Iran. METHODS: In this prospective cohort study, 387 patients with COVID-19 without diabetes, were categorized into deceased and surviving groups. We compared anthropometric and demographic data, liver function tests, CT scores, and FIB-4 indices between the groups. Multivariate logistic regression assessed the independent association of FIB-4 with mortality. RESULTS: Among the 387 patients, (all non-diabetics), 58 (15%) died, with a higher mortality rate observed in patients with a FIB-4 index≥2.6 (63.4%) compared to those with FIB-4<2.6 (29.7%). Deceased patients were considerably older and more likely to be hypertensive (P values<0.001). After adjustment of confounding factors, a FIB-4 index≥2.6 was found to be independently associated with increased mortality (OR: 13.511, 95% CI: 1.356-134.580, P=0.026). CONCLUSION: The FIB-4 index, calculable by routine laboratory tests, may be a valuable prognostic factor for COVID-19 mortality. This easily obtainable marker could help identify high-risk patients early, potentially allowing for more rapid intervention and treatment prioritization. © 2025 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.