Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19  

作　　者：Ali Madian Ahmed Eliwa Hytham Abdalla Haitham A Azeem Aly 

机构地区：[1]Department of Internal Medicine,Faculty of Medicine,Al-Azhar University-Assiut,Assiut 71524,Egypt [2]Department of Internal Medicine,Faculty of Medicine,Al-Azhar University-Cairo,Cairo 11754,Egypt [3]Department of Chest Diseases,Faculty of Medicine,Al-Azhar University-Assiut,Assiut 71524,Egypt

出　　处：《World Journal of Gastroenterology》2022年第16期1671-1680,共10页世界胃肠病学杂志（英文版）

摘　　要：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.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all 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,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accur

关 键 词：COVID-19 Aspartate transferase-to-platelet ratio index Aspartate transferase All-cause inhospital mortality Serum ferritin SARS-CoV-2 

分 类 号：R563.1[医药卫生—呼吸系统]