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The relationship between liver fibrosis scores and clinical outcomes in patients with COVID-19 is not compressively assessed. Methods. We identified relevant cohort studies that assessed the relationship between liver fibrosis scores (e.g., FIB-4, NAFLD fibrosis score (NFS), and aspartate aminotransferase to platelet ratio index (APRI)) and associated prognosis outcomes by searching the PubMed, EMBASE, and medRxiv databases. The potential dose-response effect was performed using a stage robust error meta-regression. Results. Sixteen studies with 8,736 hospitalized patients with COVID-19 were included. One-point score in FIB-4 increase was significantly associated with increased mechanical ventilation (RR: 2.23, 95% CI: 1.37\u20133.65, <jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), severe COVID-19 (RR: 1.82, 95% CI: 1.53\u20132.16, <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), and death (RR: 1.47, 95% CI: 1.31\u20131.65, <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.001<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), rather than hospitalization (RR: 1.35, 95% CI: 0.72\u20132.56, <jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.35<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>). Furthermore, there is a significant positive linear relationship between FIB-4 and severe COVID-19 (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:msub>\n                           <i:mrow>\n                              <i:mi>P<\/i:mi>\n                           <\/i:mrow>\n                           <i:mrow>\n                              <i:mtext>nonlinearity<\/i:mtext>\n                           <\/i:mrow>\n                        <\/i:msub>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.12<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>) and mortality (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:msub>\n                           <k:mrow>\n                              <k:mi>P<\/k:mi>\n                           <\/k:mrow>\n                           <k:mrow>\n                              <k:mtext>nonlinearity<\/k:mtext>\n                           <\/k:mrow>\n                        <\/k:msub>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.18<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>). Regarding other liver scores, one unit elevation in APRI increased the risk of death by 178% (RR: 2.78, 95% CI: 1.10\u20136.99, <jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>P<\/m:mi>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>0.03<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>). Higher NFS (\u2265\u22121.5) and Forns index were associated with increased risk of severe COVID-19 and COVID-19-associated death. Conclusion. Our dose-response meta-analysis suggests high liver fibrosis scores are associated with worse prognosis in patients with COVID-19. For patients with COVID-19 at admission, especially for those with coexisting chronic liver diseases, assessment of liver fibrosis scores might be useful for identifying high risk of developing severe COVID-19 cases and worse outcomes.<\/jats:p>","DOI":"10.1155\/2022\/7235860","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T17:50:58Z","timestamp":1648576258000},"page":"1-11","source":"Crossref","is-referenced-by-count":16,"title":["Liver Fibrosis Scores and Hospitalization, Mechanical Ventilation, Severity, and Death in Patients with COVID-19: A Systematic Review and Dose-Response Meta-Analysis"],"prefix":"10.1155","volume":"2022","author":[{"given":"Menglu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Seventh People\u2019s Hospital of Zhengzhou, Zhengzhou, Henan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaibo","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The People\u2019s Hospital of Shanggrao, Shanggrao, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziqi","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, The Third People\u2019s Hospital of Gan Zhou, Ganzhou, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuwei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyong","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-7686","authenticated-orcid":true,"given":"Peng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Endocrine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"Institute for the Study of Endocrinology and Metabolism in Jiangxi, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-289X","authenticated-orcid":true,"given":"Xiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute for the Study of Endocrinology and Metabolism in Jiangxi, Nanchang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.09.014"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.12.048"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.216077"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14669"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7080219"},{"key":"6","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1002\/hep.29113","article-title":"Liver fibrosis scores predict liver disease mortality in the United States population","volume":"66","author":"A. 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