tetano
Editor, Senior Moderator
Intern Med J
. 2022 May 12.
doi: 10.1111/imj.15817. Online ahead of print.
The short-term outcomes of patients with chronic liver disease hospitalized with COVID-19
Ivica Grgurevic[SUP] 1 2 3 [/SUP], Marko Lucijanić[SUP] 2 4 [/SUP], Frane Pastrovic[SUP] 1 [/SUP], Mislav Barisic Jaman[SUP] 1 [/SUP], Ida Tjesic Drinkovic[SUP] 1 [/SUP], Marko Zelenika[SUP] 1 [/SUP], Marko Milosevic[SUP] 1 [/SUP], Barbara Medic[SUP] 1 [/SUP], Dusko Kardum[SUP] 1 [/SUP], Tomislav Bokun[SUP] 1 3 [/SUP], Ivica Luksic[SUP] 2 5 [/SUP], Nevenka Piskac Zivkovic[SUP] 6 [/SUP], Tatjana Keres[SUP] 7 [/SUP], Vlatko Grabovac[SUP] 7 8 [/SUP], Jasminka Persec[SUP] 9 10 [/SUP], Bruno Barsic[SUP] 2 7 [/SUP]
Affiliations
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.
. 2022 May 12.
doi: 10.1111/imj.15817. Online ahead of print.
The short-term outcomes of patients with chronic liver disease hospitalized with COVID-19
Ivica Grgurevic[SUP] 1 2 3 [/SUP], Marko Lucijanić[SUP] 2 4 [/SUP], Frane Pastrovic[SUP] 1 [/SUP], Mislav Barisic Jaman[SUP] 1 [/SUP], Ida Tjesic Drinkovic[SUP] 1 [/SUP], Marko Zelenika[SUP] 1 [/SUP], Marko Milosevic[SUP] 1 [/SUP], Barbara Medic[SUP] 1 [/SUP], Dusko Kardum[SUP] 1 [/SUP], Tomislav Bokun[SUP] 1 3 [/SUP], Ivica Luksic[SUP] 2 5 [/SUP], Nevenka Piskac Zivkovic[SUP] 6 [/SUP], Tatjana Keres[SUP] 7 [/SUP], Vlatko Grabovac[SUP] 7 8 [/SUP], Jasminka Persec[SUP] 9 10 [/SUP], Bruno Barsic[SUP] 2 7 [/SUP]
Affiliations
- PMID: 35555962
- DOI: 10.1111/imj.15817
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.