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Low incidence of COVID-19 in a prospective cohort of patients with liver cirrhosis and hepatocellular carcinoma treated at a tertiary medical center during the 2020 pandemic.
Fründt, Thorben; Kuballa, Lilith; Lütgehetman, Marc; Nörz, Dominik; Arend, Hannes; Brehm, Thomas T; Schulze Zur Wiesch, Julian; Horvatits, Thomas; Horvatits, Karoline; Huber, Samuel; Wege, Henning; Kluwe, Johannes.
  • Fründt T; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Kuballa L; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Lütgehetman M; Institute of Microbiology and Virology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Nörz D; Institute of Microbiology and Virology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Arend H; Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
  • Brehm TT; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schulze Zur Wiesch J; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Braunschweig, Germany.
  • Horvatits T; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Horvatits K; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Huber S; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Braunschweig, Germany.
  • Wege H; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Kluwe J; Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One ; 16(12): e0258450, 2021.
Article in English | MEDLINE | ID: covidwho-1581814
ABSTRACT
BACKGROUND AND

AIMS:

Patients with liver cirrhosis (LC) are considered to be at increased risk for mortality when acquiring SARS-CoV-2 infection and subsequently developing Corona Virus Disease 2019 (COVID-19). During the COVID-19 pandemic, hospitals are regarded as sites with increased risk of infection. Therefore, patient contacts are often limited to urgent indications, which could negatively affect disease monitoring. However, data regarding actual infection rates in cirrhotic patients is limited. The aim of this prospective study was to assess the incidence of COVID-19 in patients with LC with/without hepatocellular carcinoma (HCC) with physical presentation at our University Medical Center.

METHODS:

Patients were enrolled between 1st April and 30th June 2020 at the University Medical Center Hamburg-Eppendorf, Germany. Symptoms of upper airway infection at baseline and presence of SARS-CoV-2 antibodies (IgG/IgM/IgA) were assessed at baseline and follow-up (FU) using an Electro-chemiluminescence immunoassay (Roche Elecsys). FU visits, including liver function test, clinical assessment and symptom questionnaire, were conducted after 6-8 weeks (FU-1) and 6 months (FU-2). Prior to inclusion of the first patient, obligatory face masks and personal distance were implemented as protective measures.

RESULTS:

A total of 150 patients were enrolled, 23% (n = 35) also had diagnosis of HCC (median age 64 years, range 19-86), 69% were male. Liver function according to Child-Pugh score (CPS) was CPS A 46% (n = 62); CPS B 37% (n = 50); CPS C 17% (n = 23). Clinical symptoms indicating upper airway infection were present in 53% (n = 77) shortness of breath (n = 40) and coughing (n = 28) were the most frequent. For the 150 patients enrolled, 284 outpatient visits were registered and 33 patients were admitted to the University Medical Center during the follow-up period. After a median of 52 days, n = 110 patients completed FU-1 and n = 72 completed FU-2 after a median of 6.1 months. Only in one patient, an 80-year-old man with stable liver function (CPS A) and advanced HCC, SARS-CoV-2 antibodies were detected at baseline and FU-1, while antibody testing was negative in the remaining patients at baseline, FU-1 and FU-2.

CONCLUSION:

The incidence of COVID-19 at our tertiary medical center during the pandemic was low in LC and HCC patients, when simple protective measures were implemented. Therefore, a routine care for patients with chronic liver diseases does not increase the risk of SARS-CoV-2 infection and should be maintained with protective measures.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Carcinoma, Hepatocellular / COVID-19 / Liver Cirrhosis Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Variants Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: JOURNAL.PONE.0258450

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Carcinoma, Hepatocellular / COVID-19 / Liver Cirrhosis Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid / Variants Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: JOURNAL.PONE.0258450