Liver manifestations in COVID-19 and the influence of pre-existing liver disease in the course of the infection
INTRODUCTION: patients with advanced chronic liver disease (CLD) may be at an increased risk of a severe course due to cirrhosis-associated immune dysfunction. The aim of this study was to determine the prevalence of CLD in COVID-19 patients and to analyze the course of the infection, compared with patients with non-liver disease.
MATERIALS AND METHODS: this was a retrospective single center study of all patients with a positive SARS-CoV-2 polymerase chain reaction (PCR) test from March 23rd to April 30th, 2020. Clinical and biochemical data of patients with and without CLD and COVID-19 were collected from the medical records.
RESULT: four hundred and forty-seven patients with a SARS-CoV-2 positive PCR were included, 6.3 % had CLD; 69.7 % of patients with CLD were male, with a median age of 65.5 years and active alcohol consumption and smoking; 75 % had non-advanced liver fibrosis and most had non-alcoholic fatty liver disease (NAFLD). The hospital admission rate (92.9 % vs 47.7 %, p < 0.001), concomitant comorbidities (diabetes 38.5 vs 16.5 %, p = 0.011; obesity 30.8 vs 8.5 %, p = 0.033; cancer 23.1 vs 5 %, p = 0.027; and chronic obstructive pulmonary disease (COPD) 19.2 vs 9 %, p = 0.009) and concomitant antibiotics treatment (19.3 vs 5 %, p = 0.018) were higher in patients with CLD than in those without CLD. In-patient hospital mortality rates were similar in both groups (30.8 vs 19.6 %, p = 0.289). The presence of CLD was not associated with mortality (OR = 1.06; 95 % CI = 0.35-3.18; p = 0.924). However, patients with CLD and COVID-19 who were male, obese or under concomitant antibiotic treatment had the highest risk of mortality according to the univariate analysis.
CONCLUSION: patients with CLD had a higher risk of hospital admission, with worse outcomes during the COVID-19 infection associated to other concomitant comorbidities and a suspicion of bacterial co-infection.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:113 |
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| Enthalten in: |
Revista espanola de enfermedades digestivas - 113(2021), 2 vom: 12. Feb., Seite 103-109 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Guerra Veloz, María Fernanda [VerfasserIn] |
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| Anmerkungen: |
Date Completed 25.03.2021 Date Revised 25.03.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.17235/reed.2020.7627/2020 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319573206 |
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| 100 | 1 | |a Guerra Veloz, María Fernanda |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Liver manifestations in COVID-19 and the influence of pre-existing liver disease in the course of the infection |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 25.03.2021 | ||
| 500 | |a Date Revised 25.03.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: patients with advanced chronic liver disease (CLD) may be at an increased risk of a severe course due to cirrhosis-associated immune dysfunction. The aim of this study was to determine the prevalence of CLD in COVID-19 patients and to analyze the course of the infection, compared with patients with non-liver disease | ||
| 520 | |a MATERIALS AND METHODS: this was a retrospective single center study of all patients with a positive SARS-CoV-2 polymerase chain reaction (PCR) test from March 23rd to April 30th, 2020. Clinical and biochemical data of patients with and without CLD and COVID-19 were collected from the medical records | ||
| 520 | |a RESULT: four hundred and forty-seven patients with a SARS-CoV-2 positive PCR were included, 6.3 % had CLD; 69.7 % of patients with CLD were male, with a median age of 65.5 years and active alcohol consumption and smoking; 75 % had non-advanced liver fibrosis and most had non-alcoholic fatty liver disease (NAFLD). The hospital admission rate (92.9 % vs 47.7 %, p < 0.001), concomitant comorbidities (diabetes 38.5 vs 16.5 %, p = 0.011; obesity 30.8 vs 8.5 %, p = 0.033; cancer 23.1 vs 5 %, p = 0.027; and chronic obstructive pulmonary disease (COPD) 19.2 vs 9 %, p = 0.009) and concomitant antibiotics treatment (19.3 vs 5 %, p = 0.018) were higher in patients with CLD than in those without CLD. In-patient hospital mortality rates were similar in both groups (30.8 vs 19.6 %, p = 0.289). The presence of CLD was not associated with mortality (OR = 1.06; 95 % CI = 0.35-3.18; p = 0.924). However, patients with CLD and COVID-19 who were male, obese or under concomitant antibiotic treatment had the highest risk of mortality according to the univariate analysis | ||
| 520 | |a CONCLUSION: patients with CLD had a higher risk of hospital admission, with worse outcomes during the COVID-19 infection associated to other concomitant comorbidities and a suspicion of bacterial co-infection | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Cordero Ruiz, Patricia |e verfasserin |4 aut | |
| 700 | 1 | |a Ríos-Villegas, María José |e verfasserin |4 aut | |
| 700 | 1 | |a Del Pino Bellido, Pilar |e verfasserin |4 aut | |
| 700 | 1 | |a Bravo-Ferrer, José |e verfasserin |4 aut | |
| 700 | 1 | |a Galvés Cordero, Rocío |e verfasserin |4 aut | |
| 700 | 1 | |a Cadena Herrera, María Lorena |e verfasserin |4 aut | |
| 700 | 1 | |a Vías Parrado, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Bellido Muñoz, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Vega Rodríguez, Francisco |e verfasserin |4 aut | |
| 700 | 1 | |a Caunedo Álvarez, Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Baño, Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Carmona Soria, Isabel |e verfasserin |4 aut | |
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