Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 28 2 2025 02 01 FIB-4 Index Can Predict Mortality in Hospitalized Patients with COVID-19 Infection, Independent of CT Severity Score 88 94 10.34172/aim.33514 EN Faeze Salahshour https://orcid.org/0000-0002-0342-0006 Sahar Karimpour Reyhan https://orcid.org/0000-0003-2669-6942 Kazem Zendedel Kiana Seifouri Monireh Sadat Seyyedsalehi Parnian Naghavi Mahsa Abbaszadeh Alireza Esteghamati Manouchehr Nakhjavani Soghra Rabizadeh https://orcid.org/0000-0002-3752-302X Journal Article 10.34172/aim.33514 2024 11 19 2025 01 01 Background: The fibrosis 4 (FIB-4) index is typically used in assessing liver fibrosis, and has shown potential in predicting the outcome in various diseases. This study aims to evaluate the predictive power of the FIB-4 index for mortality in COVID-19 patients admitted to a reference hospital in Tehran, Iran. Methods: In this prospective cohort study, 387 patients with COVID-19 without diabetes, were categorized into deceased and surviving groups. We compared anthropometric and demographic data, liver function tests, CT scores, and FIB-4 indices between the groups. Multivariate logistic regression assessed the independent association of FIB-4 with mortality. Results: Among the 387 patients, (all non-diabetics), 58 (15%) died, with a higher mortality rate observed in patients with a FIB-4 index≥2.6 (63.4%) compared to those with FIB-4<2.6 (29.7%). Deceased patients were considerably older and more likely to be hypertensive (P values<0.001). After adjustment of confounding factors, a FIB-4 index≥2.6 was found to be independently associated with increased mortality (OR: 13.511, 95% CI: 1.356-134.580, P=0.026). Conclusion: The FIB-4 index, calculable by routine laboratory tests, may be a valuable prognostic factor for COVID-19 mortality. This easily obtainable marker could help identify high-risk patients early, potentially allowing for more rapid intervention and treatment prioritization.