ABSTRACT
Introduction: Patient with chronic liver disease (CLD) can have adverse outcomes in setting of COVID-19 infection. Our goal is to determine the prevalence of liver disease in COVID-19 infection and outcomes as compared to individuals without CLD. Methods: We conducted a retrospective review of the patients admitted for COVID-19 infection from March 1st, 2020 till May 31st, 2020. The patients who had chronic liver disease were identified based on imaging interpretation and chronically elevated liver enzymes. Chart review was done for 332 patients, the one with missing data were excluded (n=16). We included 316 patients in the analysis. Of them 12.0% patients had underlying chronic liver disease. Results: Of total 43.7% were female and 48.4% were Caucasians. The patients with liver disease were older (64.6 ± 15.3 vs 57.6 ± 17.4, p=0.02) as compared to non-CLD. The CLD patients had higher number of coronary artery disease (47.4% vs 18.9%, p<0.001). The other comorbid conditions including chronic obstructive pulmonary disease, asthma, cancer, chronic kidney disease, diabetes mellitus, hypertension, obesity, obstructive sleep apnea and smoking were similar in both groups. The CLD patients had higher mortality (aOR: 3.3, 95% CI: 1.37-8.05), thromboembolism (aOR: 3.77, 95% CI: 1.33-10.71), acute respiratory distress syndrome (aOR:2.25, 95% CI: 1.04-4.85) and trend of severe COVID-19 infection (aOR:1.90, 95% CI:0.91-3.98) whereas the 3 month readmission was similar in both groups. The Kaplan Meier survival curve suggest that COVID-19 patients with CLD died early during the study period. Conclusion: The presence of chronic liver disease in inpatient COVID-19 infections is associated with three fold higher mortality. The CLD patients had higher incidence of severe infection. $Φgure