Quality of life in the cirrhosis registry during the SARS-CoV-2 lockdown in Slovakia

Abstract

Introduction: Liver cirrhosis is associated with a poor quality of life (QOL). The SARS-CoV-2 coronavirus pandemic has led to several restriction measures and psychosocial consequences whose impact on QOL has combined with that of cirrhosis in an unknown way. Therefore, we have used our cirrhosis registry to assess quality of life before the pandemic (at the first admission to the tertiary liver unit) and during the most pronounced phase of the first lockdown. Materials and Methods: In this cross-sectional study conducted during the first lockdown in Slovakia (from April to May 2020), we have repeated the QOL measurement of QOL in cirrhotic patients previously enrolled in the RH7 registry. Of the entire RH7 cohort, we have identified patients who were alive (according to the national registry of deaths) and contacted them by phone with a structured and standardized interview led by trained professionals. The tool used for both QOL measurements (at enrolment to RH7 and during the lockdown) was standardized and validated EuroQol-5D (EQ-5D) questionnaire. Results: The study included 97 patients, of which 37 (38.1%) were women and 60 (61.9%) were men. Responses were achieved from 75 patients (68,18%). In general, patients have scored their quality of life significantly higher during the pandemic compared to examination at admission to RH7 (that is, on admission to our tertiary liver unit with cirrhosis) (p = 0.005). In particular, of the domains included in EQ-5D, I.) self-care was better during lockdown compared to the first record on admission to RH7 (p<0.001); II.) the ability to perform daily activities has also improved during lockdown (p = 0.002); on the other hand, III.) pain and discomfort have not changed significantly during lockdown compared with previous measurement (p = 0.882), IV.) anxiety and depression were lower during lockdown compared to admission to RH7 (p = 0.01). Conclusion: The quality of life in patients with liver cirrhosis was better during the lockdown of SARS-CoV-2 compared to the previous measurement at admission to the tertiary liver unit.