The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients

<b>Background/Objectives</b>: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. <b>Methods</b>: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (<i>n</i> = 139) and non-survivors (<i>n</i> = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. <b>Results</b>: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; <i>p</i> = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio [HR] = 1.83; 95% confidence interval [CI]: 1.2-2.8; <i>P</i><sub>corrected</sub> = 0.03) was an independent predictor for mortality of COVID-19. <b>Conclusions</b>: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.

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Journal
Journal of Clinical Medicine
Published
2024-09-27
DOI
https://doi.org/10.3390/jcm13195777
Citations
1
Primary Topic
COVID-19 Clinical Research Studies
Type
article
Field-Weighted Citation Impact
0.39

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article

The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients

Gustavo Martínez-Mier, Luis Adrián De Jesús‐González, Carlos Noe Farfán-Morales, Moisés León‐Juárez et al.
1 citations
Journal of Clinical Medicine
COVID-19 Clinical Research Studies
0.39
article

The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients

Gustavo Martínez-Mier, Luis Adrián De Jesús‐González, Carlos Noe Farfán-Morales, Moisés León‐Juárez, Víctor Bernal-Dolores, Selvin Noé Palacios-Rápalo, Rosa María del Ángel, Juan Fidel Osuna‐Ramos, José Manuel Reyes-Ruíz, Ana Citlali Avelino-Santiago, Claudia Vanessa López-López
article en
1 citations

Abstract

<b>Background/Objectives</b>: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. <b>Methods</b>: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (<i>n</i> = 139) and non-survivors (<i>n</i> = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. <b>Results</b>: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; <i>p</i> = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio [HR] = 1.83; 95% confidence interval [CI]: 1.2-2.8; <i>P</i><sub>corrected</sub> = 0.03) was an independent predictor for mortality of COVID-19. <b>Conclusions</b>: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.

Journal of Clinical MedicineVol. 13(19)
Institut Pasteur (FR), Mexican Social Security Institute (MX), Universidad Autónoma de Sinaloa (MX), Universidad Autónoma Metropolitana (MX), Instituto Nacional de Perinatología (MX), Hospital de Especialidades (MX), Universidad Autónoma de Zacatecas "Francisco García Salinas" (MX), Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional (MX), Benemérita Universidad Autónoma de Puebla (MX)
Instituto Mexicano del Seguro Social
Good health and well-being
Openalex Percentile: Top 36%
COVID-19 Clinical Research Studies
0.39
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