A significant predictor of in-hospital and long-term mortality and progression in COVID-19 patients: The end-stage liver disease (MELD) score model.

Abstract

The aim of this study is to investigate the relationship between the model for end‐stage liver disease (MELD) score and disease progression and mortality in COVID‐19 patients. The files of 4213 patients over the age of 18 who were hospitalized with the diagnosis of COVID‐19 between March 20, 2020 and May 1, 2021 were retrospectively scanned. Sociodemographic characteristics, chronic diseases, hemogram and biochemical parameters at the time they were diagnosed with COVID‐19 of the patients, duration of hospitalization, duration of intensive care unit (ICU), duration of intubation, in‐hospital mortality from COVID‐19 and outside‐hospital mortality for another reason (within the last 1 year) and recurrent hospitalization (within the last 1 year) were recorded. The MELD scores of the patients were calculated. Two groups were formed as MELD score < 10 and MELD score ≥ 10. The rate of ICU, in‐hospital mortality from COVID‐19 and outside‐hospital mortality from other causes, intubation rate, and recurrent hospitalization were significantly higher in the MELD ≥ 10 group. The duration of ICU, hospitalization, intubation were significantly higher in the MELD ≥ 10 group (p < 0.001). As a result of Univariate and Multivariate analysis, MELD score was found to be the independent predictors of ICU, in‐hospital mortality, intubation, and recurrent hospitalization (p < 0.001). MELD score 18.5 predicted ICU with 99% sensitivity and 100% specificity (area under curve [AUC]: 0.740, 95% confidence interval [CI]: 0.717–0.763, p < 0.001) also MELD score 18.5 predicted in‐hospital mortality with 99% sensitivity and 100% specificity (AUC: 0.797, 95% CI: 0.775–0.818, p < 0.001). The MELD score was found to be the independent predictors of in‐hospital mortality, ICU admission, and intubation in COVID‐19 patients.