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High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study.
Xiao, Yong; Wu, Dongwen; Shi, Xiao; Liu, Shuzhong; Hu, Xudong; Zhou, Chenliang; Tian, Xia; Liu, Huimin; Long, Hui; Li, Zhihong; Wang, Ji; Tan, Tao; Xu, Ying; Chen, Bitao; Liu, Ting; Zhang, Heng; Zheng, Shihua; Hu, Shunlin; Song, Jun; Tang, Jie; Song, Jichun; Cheng, Zhengwei; Xu, Weitian; Shen, Yongxiang; Yu, Wenhu; Xu, Yong; Li, Jiao; Zhou, Jing; Wang, Fen; Chen, Mingkai.
  • Xiao Y; Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Wu D; Department of Gastroenterology, The Third XiangYa Hospital Central South University, Changsha, Hunan, China.
  • Shi X; Department of Gastroenterology, The Third XiangYa Hospital Central South University, Changsha, Hunan, China.
  • Liu S; Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Hu X; Department of Gastroenterology, Wuhan Jinyintan Hospital, Wuhan, Hubei, China.
  • Zhou C; Intensive Care Unit, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Tian X; Department of Gastroenterology, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, Hubei, China.
  • Liu H; Department of Gastroenterology, The Second Affiliated Hospital of Jianghan University (Wuhan Fifth Hospital), Wuhan, Hubei, China.
  • Long H; Department of Gastroenterology, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan, Hubei, China.
  • Li Z; Emergency Center, the Central Hospital of Xiaogan, Xiaogan, Hubei, China.
  • Wang J; Department of Gastroenterology, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, China.
  • Tan T; Department of Gastroenterology, Third People's Hospital of Hubei Provincial, Wuhan, Hubei, China.
  • Xu Y; Department of Gastroenterology, Wuhan Hankou Hospital, Wuhan, Hubei, China.
  • Chen B; Department of Gastroenterology, Jingmen No.1 People's Hospital, Jingmen, Hubei, China.
  • Liu T; Department of Gastroenterology, Wuhan Ninth Hospital, Wuhan, Hubei, China.
  • Zhang H; Department of Gastroenterology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Zheng S; Department of Gastroenterology, Yichang Central People's Hospital, Yichang, Hubei, China.
  • Hu S; Department of Gastroenterology, Xiangyang No.1 People's Hospita, Xiangyang, Hubei, China.
  • Song J; Department of Gastroenterology, Union Hospital Affiliated to Huazhong University of Science and Technology, Wuhan, Hubei, China.
  • Tang J; Department of Orthopedic, Wuhan Fourth Hospital, Wuhan, Hubei, China.
  • Song J; Department of Gastroenterology, Chibi Genral Hospital, Chibi, Hubei, China.
  • Cheng Z; Department of Gastroenterology, Tongji Xianning Hospital, Huazhong University of Science and Technology, Xianning, Hubei, China.
  • Xu W; Department of Gastroenterology, Central Theater General Hospital, Wuhan, Hubei, China.
  • Shen Y; Department of Gastroenterology, The First People's Hospital of Tianmen Hubei Province, Tianmen, Hubei, China.
  • Yu W; Department of Gastroenterology, Xiantao First People's Hospital, Xiantao, China.
  • Xu Y; Department of Gastroenterology, Tongcheng People's Hospital, Tongcheng, Hubei, China.
  • Li J; Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Zhou J; Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
  • Wang F; Department of Gastroenterology, The Third XiangYa Hospital Central South University, Changsha, Hunan, China.
  • Chen M; Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Virulence ; 12(1): 1199-1208, 2021 12.
Article in English | MEDLINE | ID: covidwho-1192789
ABSTRACT

Background:

COVID-19 has rapidly become a major health emergency worldwide. The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear.

Methods:

Medical records were collected from 23 Chinese hospitals. Patients with decompensated cirrhosis and age- and sex-matched non-liver disease patients were enrolled with 14 ratio using stratified sampling.

Results:

There were more comorbidities with higher Chalson Complication Index (p < 0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p < 0.05) and in decompensated cirrhosis patients. Mortality (p < 0.05) and the proportion of severe ill (p < 0.001) were significantly high among those patients. Patients in severe ill subgroup had higher mortality (p < 0.001), MELD, and CRUB65 score but lower lymphocytes count. Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p < 0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance. Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome. Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores.

Conclusions:

COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality. MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / SARS-CoV-2 / COVID-19 / Liver Cirrhosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Virulence Year: 2021 Document Type: Article Affiliation country: 21505594.2021.1909894

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Severity of Illness Index / SARS-CoV-2 / COVID-19 / Liver Cirrhosis Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Virulence Year: 2021 Document Type: Article Affiliation country: 21505594.2021.1909894