Trends in aetiology-based hospitalisation for cirrhosis before and during the COVID-19 pandemic in the United States.
Aliment Pharmacol Ther
; 58(2): 218-228, 2023 Jul.
Article
in English
| MEDLINE | ID: covidwho-2316072
ABSTRACT
BACKGROUND AND AIMS:
Patients with pre-existing cirrhosis and exposure to coronavirus disease-19 (COVID-19) may portend a poor prognosis. We evaluated the temporal trends in aetiology-based hospitalisations and potential predictors of in-hospital mortality in hospitalisation with cirrhosis before and during the COVID-19 pandemic.METHODS:
Based on the US National Inpatient Sample 2019-2020, we determined quarterly trends in aetiology-based hospitalisations with cirrhosis and decompensated cirrhosis and identified predictors of in-hospital mortality in hospitalisation with cirrhosis.RESULTS:
We analysed 316,418 hospitalisations, representing 1,582,090 hospitalisations with cirrhosis. Hospitalisations for cirrhosis increased at a relatively higher rate during the COVID-19 era. Hospitalisation rates for alcohol-related liver disease (ALD)-related cirrhosis increased significantly (quarterly percentage change [QPC] 3.6%, 95% CI 2.2%-5.1%), with a notably higher rate during the COVID-19 era. In contrast, hospitalisation rates for hepatitis C virus (HCV)-related cirrhosis decreased steadily with a trend of -1.4% of QPC (95% CI -2.5% to -0.1%). Quarterly trends in the proportion of ALD- (QPC 1.7%, 95% CI 0.9%-2.6%) and nonalcoholic fatty liver disease-related (QPC 0.7%, 95% CI 0.1%-1.2%) hospitalisations with cirrhosis increased significantly but declined steadily for viral hepatitis. The COVID-19 era and COVID-19 infection were independent predictors of in-hospital mortality during hospitalisation with cirrhosis and decompensated cirrhosis. Compared with HCV-related cirrhosis, ALD-related cirrhosis was associated with a 40% higher risk of in-hospital mortality.CONCLUSION:
In-hospital mortality in cirrhosis was higher in the COVID-19 era than in the pre-COVID-19 era. ALD is the leading aetiology-specific cause of in-hospital mortality in cirrhosis with an independent detrimental impact of the COVID-19 infection.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Hepatitis C
/
COVID-19
Type of study:
Etiology study
/
Experimental Studies
/
Prognostic study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Aliment Pharmacol Ther
Journal subject:
Pharmacology
/
Gastroenterology
/
Drug Therapy
Year:
2023
Document Type:
Article
Affiliation country:
Apt.17547
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