The Outcome in Cirrhosis after Hospital Discharge is Not Worsened with COVID-19 Infection: A Propensity Score-matched Analysis.
J Clin Exp Hepatol
; 12(3): 830-840, 2022.
Article
in English
| MEDLINE | ID: covidwho-1540738
ABSTRACT
Background:
Patients with cirrhosis and coronavirus disease-2019 (COVID-19) have high in-hospital mortality. The information on the outcome of cirrhosis patients in the posthospitalization period is limited.Aims:
We aimed to study the outcome of cirrhosis patients with COVID-19 after hospital discharge.Methods:
The records of the cirrhosis patients discharged after COVID-19 were reviewed. Their data were compared with a similar number of cirrhosis patients without COVID-19 after propensity score matching for age, sex, etiology of cirrhosis, and model for end-stage liver disease (MELD) score.Results:
Cirrhosis patients with (n = 92) or without (n = 92) COVID-19 were included in 11 ratio. The mortality among COVID-19 (22; 23.9%) and non-COVID-19 (19; 20.7%) were comparable (HR 1.224; 95% CI 0.663-2.263, P = 0.520), over a similar duration of follow-up [186 (86-271) vs. 183 (103-274)]. Among COVID-19 patients, 45; 48.9% developed a new acute decompensation-increased ascites (40; 43.5%), hepatic encephalopathy (20; 21.7%), or variceal bleeding (8; 8.7%) whereas 25 (27.2%) patients needed rehospitalization. A proportion of participants continued to have either fatigue/weakness (24/80; 30.0%), sleep disturbances (11/80; 13.7%), or joint pains (16/80; 20.0%). The most common causes of death in patients of both groups were end-stage liver disease 16 (72.7%) vs. 9 (47.4%), followed by multiorgan dysfunction 4 (18.2%) vs. 6 (31.6%), GI bleeding 2 (9.1%) vs. 4 (21.0%), P = 0.484. A lower albumin level, higher international normalized ratio, bilirubin, Child-Turcotte-Pugh, and MELD scores at discharge predicted mortality in the COVID-19 group.Conclusion:
Short-term outcomes of patients with cirrhosis who survive the initial insult of COVID-19 are not different from patients without COVID-19, and survival is determined by the severity of liver disease at discharge.
ACE2, Angiotensin-converting enzyme 2; AD, acute decompensation; AIH, autoimmune hepatitis; ALT, alanine aminotransferase; AST, aspartate aminotransferase; Alk P, alkaline phosphatase; COVID-19, coronavirus disease-2019; CTP, Child-Turcotte-Pugh; GI, Gastrointestinal; HBV, hepatitis B virus; HCV, hepatitis C virus; INR, international normalized ratio; IQR, interquartile range; MELD, model for end-stage liver disease; NAFLD, nonalcoholic fatty liver disease; TLC, Total leukocyte count; chronic liver disease; coronavirus; mortality; pandemic; virus
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Etiology study
/
Experimental Studies
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
J Clin Exp Hepatol
Year:
2022
Document Type:
Article
Affiliation country:
J.jceh.2021.11.009
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