Short‐term outcomes of patients with chronic liver disease hospitalised with COVID‐19

Abstract

Background and aims Patients with chronic liver disease (CLD) might have aggravated course upon acquisition of coronavirus disease 2019 (COVID‐19). We aimed to analyse the outcomes of patients with CLD who were hospitalized due to COVID‐19. Methods Medical records of 4014 patients hospitalized due to COVID‐19 in a regional referral hospital over a 12‐month period were analysed. Patients with CLD were identified based on discharge diagnoses according to ICD‐10 classification. Patients were followed for 30 days from admission, and their outcomes (intensive care unit (ICU) admission, mechanical ventilation (MV) or death) were analysed. Results Of the 4014 patients, 110 (2.7%) had CLD and 49 (1.2%) had cirrhosis. Median age of CLD patients was 67.5 years, 79 (71.8%) were males, 224 (23.5%) obese, 56 (50.9%) reported alcohol abuse, 24 (21.8%) had non‐alcoholic fatty liver disease, 11 (10%) viral hepatitis and 98 (89.1%) had pneumonia. Median length of hospitalization was 12 days, 32 (29.1%) patients required ICU admission and 23 (20.9%) MV, while 43 (39.1%) died. In univariate analysis, patients with cirrhosis (45% vs 73%, HR=2.95; P<0.001), but not those with non‐cirrhotic CLD (74% vs 73%, P>0.05), experienced worse 30‐days survival when compared to age, sex and COVID‐19 duration matched cohorts. In a logistic regression analysis conducted on the overall and matched cohorts, liver cirrhosis, but not CLD, predicted inferior survival independently of age, comorbidities and severity of COVID‐19, with a fourfold higher adjusted risk of 30‐day mortality. Conclusion Cirrhosis is independently associated with higher 30‐day mortality of hospitalized patients with COVID‐19. This article is protected by copyright. All rights reserved.

COVID-19 Alcoholic Cirrhosis and Non-Alcoholic Steatohepatitis Cirrhosis Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample Database

“…Similarly, hospitalisations for CC+ were higher in patients above 70 years of age, as well as patients with comorbidities. This is consistent with current literature reports [13,20,27].…”

“…There have been few studies characterising the outcomes of patients with cirrhosis and COVID-19 based on the etiology of cirrhosis. In a single-center study of patients with chronic liver disease of mostly alcoholic etiology, hospitalised for COVID-19, presence of cirrhosis was associated with fourfold increase in 30 day mortality compared to patients without cirrhosis [13]. Yoo et al showed that patients with pre-existing NAFLD have a higher likelihood of testing positive for COVID-19, and are more predisposed to severe illness [14].Additionally, Kim et al showed that the etiology of all-cause mortality from alcoholic liver disease and non-alcoholic fatty liver disease increased significantly during the COVID-19 pandemic, with increase in cirrhosis-related mortality mainly attributable to alcoholic liver disease [15].…”

Mortality risk and associated factors in cirrhosis patients with SARS-CoV-2 infection

“…Additionally, a study by Sohail et al identified chronic kidney disease, cardiovascular diseases, and intensive care admission as predictors for mortality in cirrhotic patients hospitalized with COVID-19 23 . However, other studies have found that chronic kidney disease and cardiovascular diseases were not predictors for mortality in cirrhotic patients hospitalized with COVID-19 infection 24,25 . In this study, both WBC and serum albumin were found to be predictors of death in cirrhotic patients with COVID-19.…”

The impact of COVID-19 disease on the natural course of cirrhosis: Before and after starting vaccination

“…One of the remarkable findings in our patient group is that almost a quarter of them were infected with COVID-19, despite the patient cohort were being well-informed and had strictly adhered to precautions in the pre-vaccine period. Cirrhosis has been shown in a recent study as a risk factor for short-term mortality ( 17 ). COVID-19 infection was fatal in 16% of our patients.…”