ABSTRACT
BACKGROUND: Specific associations between liver cirrhosis and liver transplant with poorer outcomes in COVID-19 are still not completely clear. OBJECTIVE: We aimed to evaluate the clinical characteristics and outcomes of patients with severe COVID-19 and cirrhosis or liver transplant in Sao Paulo, Brazil. METHODS: A retrospective observational study was conducted in a quaternary hospital. Patients with COVID-19 and liver cirrhosis or liver transplant were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records. RESULTS: A total of 46 patients with COVID-19 and liver condition were included in the study. Patients with liver cirrhosis had significantly more endotracheal intubation and a higher relative risk of death than liver transplant recipients. Patients with higher MELD-Na scores had increased death rates and lower survival probability and survival time. CONCLUSION: Patients with liver cirrhosis, especially those with higher MELD-Na scores, had poorer outcomes in COVID-19. Liver transplant recipients do not seem to be linked to poorer COVID-19 outcomes.
Subject(s)
COVID-19 , Liver Cirrhosis , Liver Transplantation , Severity of Illness Index , Humans , COVID-19/complications , Liver Transplantation/statistics & numerical data , Male , Female , Liver Cirrhosis/surgery , Retrospective Studies , Middle Aged , Brazil/epidemiology , Aged , Adult , SARS-CoV-2ABSTRACT
ABSTRACT Background: Specific associations between liver cirrhosis and liver transplant with poorer outcomes in COVID-19 are still not completely clear. Objective: We aimed to evaluate the clinical characteristics and outcomes of patients with severe COVID-19 and cirrhosis or liver transplant in Sao Paulo, Brazil. Methods: A retrospective observational study was conducted in a quaternary hospital. Patients with COVID-19 and liver cirrhosis or liver transplant were selected. The clinical and demographic characteristics, as well as the outcomes, were assessed using electronic records. Results: A total of 46 patients with COVID-19 and liver condition were included in the study. Patients with liver cirrhosis had significantly more endotracheal intubation and a higher relative risk of death than liver transplant recipients. Patients with higher MELD-Na scores had increased death rates and lower survival probability and survival time. Conclusion: Patients with liver cirrhosis, especially those with higher MELD-Na scores, had poorer outcomes in COVID-19. Liver transplant recipients do not seem to be linked to poorer COVID-19 outcomes.
RESUMO Contexto: Associações específicas entre cirrose hepática ou transplante de fígado e piores desfechos na COVID-19 ainda não estão completamente claras. Objetivo: Nosso objetivo foi avaliar as características e desfechos clínicos de pacientes com COVID-19 grave e cirrose ou transplante de fígado em São Paulo, Brasil. Métodos: Foi realizado um estudo observacional retrospectivo em um hospital quaternário. Foram selecionados pacientes com COVID-19 e cirrose hepática ou transplante de fígado. As características clínicas e demográficas, bem como os desfechos, foram avaliados por meio de prontuários eletrônicos. Resultados: Um total de 46 pacientes com COVID-19 e problemas hepáticos foram incluídos no estudo. Pacientes com cirrose hepática tiveram significativamente mais intubação endotraqueal e maior risco relativo de morte do que pacientes transplantados. Pacientes com pontuações MELD-Na mais altas apresentaram taxas de mortalidade aumentadas e menor probabilidade e tempo de sobrevivência. Conclusão: Pacientes com cirrose hepática, especialmente aqueles com escores MELD-Na mais elevados, tiveram piores desfechos na COVID-19. Os pacientes com transplante hepáticos não parecem estar associados a piores desfechos da COVID-19.
