scholarly journals FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

2021 ◽  
Vol 10 (19) ◽  
pp. 4355
Author(s):  
Marko Zelenika ◽  
Marko Lucijanic ◽  
Tomislav Bokun ◽  
Tonci Bozin ◽  
Mislav Barisic Jaman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Clinical Severity ◽  
Composite Outcome ◽  
High Flow Nasal Cannula ◽  
Liver Stiffness Measurement ◽  
Non Invasive ◽  
History Of

Background: Liver involvement in Coronavirus disease 2019 (COVID-19) has been recognised. We aimed to investigate the correlation of non-invasive surrogates of liver steatosis, fibrosis and inflammation using transient elastography (TE) and FibroScan-AST (FAST) score with (a) clinical severity and (b) 30-day composite outcome of mechanical ventilation (MV) or death among patients hospitalized due to COVID-19. Method: Patients with non-critical COVID-19 at admission were included. Liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were assessed by TE. Clinical severity of COVID-19 was assessed by 4C Mortality Score (4CMS) and need for high-flow nasal cannula (HFNC) oxygen supplementation. Results: 217 patients were included (66.5% males, median age 65 years, 4.6% with history of chronic liver disease). Twenty-four (11.1%) patients met the 30-day composite outcome. Median LSM, CAP and FAST score were 5.2 kPa, 274 dB/m and 0.31, respectively, and neither was associated with clinical severity of COVID-19 at admission. In multivariate analysis FAST > 0.36 (OR 3.19, p = 0.036), 4CMS (OR 1.68, p = 0.002) and HFNC (OR 7.03, p = 0.001) were independent predictors of adverse composite outcome. Conclusion: Whereas LSM and CAP failed to show correlation with COVID-19 severity and outcomes, FAST score was an independent risk factor for 30-day mortality or need for MV.

scholarly journals Diagnostic Accuracy of FibroScan and Factors Affecting Measurements

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 940 ◽  
Author(s):  
Satoshi Oeda ◽  
Kenichi Tanaka ◽  
Ayaka Oshima ◽  
Yasue Matsumoto ◽  
Eisaburo Sueoka ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
The Body ◽  
Liver Stiffness Measurement ◽  
Alcoholic Fatty Liver ◽  
Factors Affecting ◽  
Non Invasive ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Evaluating liver steatosis and fibrosis is important for patients with non-alcoholic fatty liver disease. Although liver biopsy and pathological assessment is the gold standard for these conditions, this technique has several disadvantages. The evaluation of steatosis and fibrosis using ultrasound B-mode imaging is qualitative and subjective. The liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) determined using FibroScan are the evidence-based non-invasive measures of liver fibrosis and steatosis, respectively. The LSM and CAP measurements are carried out simultaneously, and the median values of more than ten valid measurements are used to quantify liver fibrosis and steatosis. Here, we demonstrate that the reliability of the LSM depends on the interquartile range to median ratio (IQR/Med), but CAP values do not depend on IQR/Med. In addition, the LSM is affected by inflammation, congestion, and cholestasis in addition to fibrosis, while CAP values are affected by the body mass index in addition to steatosis. We also show that the M probe provides higher LSM values but lower CAP values than the XL probe in the same population. However, there was no statistically significant difference between the diagnostic accuracies of the two probes. These findings are important to understand the reliability of FibroScan measurements and the factors influencing measurement values for all patients.

scholarly journals Correlation of Hepatic Steatosis with Hepatic Fibrosis in NAFLD Patients by Fibroscan

2020 ◽  
Vol 9 (3) ◽  
pp. 1-7
Author(s):  
Rishabh Sehgal ◽  
Jyotisterna Mittal ◽  
Inderpal Singh
Keyword(s):  
Hepatic Steatosis ◽  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Controlled Attenuation Parameter ◽  
Nonalcoholic Fatty Liver ◽  
Attenuation Parameter ◽  
History Of ◽  
The Mean

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a significant cause of liver injury in the world. Transient elastography with controlled attenuation parameter (CAP) is now days commonly used as a non-invasive modality to quantify liver steatosis and stage of Fibrosis in the Liver. This study was done to the correlation of hepatic Steatosis with hepatic Fibrosis in NAFLD Patients by fibroscan. Subjects and Methods: All NAFLD patients coming to DMCH from 1/1/18 to 30/11/18 were retrospectively analysed for the presence of any correlation between Steatosis and Fibrosis using a controlled attenuation parameter (CAP) and liver stiffness measurement (kPa), respectively by Fibroscan. Patients with a history of significant alcohol intake, viral infection, severe weight loss, on TPN, on drugs like amiodarone, diltiazem, steroids were excluded. Along with this history of hypertension, diabetes and smoking were noted from the available data. Results: The mean CAP of all 446 patients was 310.58  53.55 and the mean kPa was 7.14   4.75. Overall there was a significant correlation between CAP and kPa in all NAFLD patients (p <0.000). This was also true in patients who were more than 20 years of age, who have increased levels of triglycerides and were obese. Patients with S0 steatosis had a mean kPa value of 5.33 and as the steatosis stage worsened to S3 mean kPa value also increased to a maximum of 7.63. Conclusion: Quantification of Steatosis by CAP has a significant correlation with the stage of Fibrosis, especially in patients with increasing age, obese and who have high triglyceride levels.

scholarly journals Microbiota analysis and transient elastography reveal new extra-hepatic components of liver steatosis and fibrosis in obese patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicolas Lanthier ◽  
Julie Rodriguez ◽  
Maxime Nachit ◽  
Sophie Hiel ◽  
Pierre Trefois ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Transient Elastography ◽  
Fasting Blood Glucose ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Multivariate Logistic Regression Analysis ◽  
Rrna Gene ◽  
Obese Patients ◽  
Skeletal Muscle Index ◽  
Linear Discriminant

AbstractObesity could lead to metabolic dysfunction-associated fatty liver disease (MAFLD), which severity could be linked to muscle and gut microbiota disturbances. Our prospective study enrolled 52 obese patients whose MAFLD severity was estimated by transient elastography. Patients with severe steatosis (n = 36) had higher ALAT values, fasting blood glucose levels as well as higher visceral adipose tissue area and skeletal muscle index evaluated by computed tomography. Patients with fibrosis (n = 13) had higher ASAT values, increased whole muscle area and lower skeletal muscle density index. In a multivariate logistic regression analysis, myosteatosis was the strongest factor associated with fibrosis. Illumina sequencing of 16S rRNA gene amplicon was performed on fecal samples. The relative abundance of fecal Clostridium sensu stricto was significantly decreased with the presence of liver fibrosis and was negatively associated with liver stiffness measurement and myosteatosis. In addition, 19 amplicon sequence variants were regulated according to the severity of the disease. Linear discriminant analysis effect size (LEfSe) also highlighted discriminant microbes in patients with fibrosis, such as an enrichment of Enterobacteriaceae and Escherichia/Shigella compared to patients with severe steatosis without fibrosis. All those data suggest a gut-liver-muscle axis in the pathogenesis of MAFLD complications.

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