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.
Authors
- Gustavo Martínez-Mier (ORCID: https://orcid.org/0000-0002-2883-9188)
- Luis Adrián De Jesús‐González (ORCID: https://orcid.org/0000-0003-1415-6260)
- Carlos Noe Farfán-Morales (ORCID: https://orcid.org/0000-0002-9787-5588)
- Moisés León‐Juárez (ORCID: https://orcid.org/0000-0002-5726-5953)
- Víctor Bernal-Dolores (ORCID: https://orcid.org/0009-0008-0018-3464)
- Selvin Noé Palacios-Rápalo (ORCID: https://orcid.org/0000-0002-2184-6529)
- Rosa María del Ángel (ORCID: https://orcid.org/0000-0002-6785-2035)
- Juan Fidel Osuna‐Ramos (ORCID: https://orcid.org/0000-0001-8280-9812)
- José Manuel Reyes-Ruíz (ORCID: https://orcid.org/0000-0002-2379-8591)
- Ana Citlali Avelino-Santiago
- Claudia Vanessa López-López
Institutions
- 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)
Publication Details
- 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
Funders
- Instituto Mexicano del Seguro Social