Liver fibrosis indices predict length of hospitalization and mortality in SARS-CoV-2 infected patients

Abstract Background: The ongoing COVID-19 pandemic has challenged health systems under multiple aspects. The deep understanding of risk and prognostic factors for this disease may help not only in reducing severity and mortality but also in targeting therapies considering patients’ individual features. Liver Fibrosis is considered a complication in Non-alcoholic Fatty Liver Disease (NAFLD), being a feature of steatohepatitis (NASH), and it had already been related to an increased risk for a wide range of diseases. Methods: Here, we analysed a sample of 271 patients with moderate-to-severe SARS-CoV-2-related respiratory failure, hospitalized in a sub-intensive care Unit, with the aim of unveiling if any condition may predict their prognosis and mortality. Results: We found that non-invasive scores of liver fibrosis such as AAR, FIB-4 and mFIB-4, Forns, and AARPRI strongly predict not only in-hospital mortality but also the length of hospitalization and the eventual admission to intensive care units. Conclusions: Thus, pre-existing liver metabolic disease is a net predictor of poor prognosis in SARS-CoV-2 infected patients admitted to Sub-Intensive Care Unit.