Clinical outcomes of coronavirus disease 2019 in patients with pre-existing liver diseases: A multicenter study in South Korea

Abstract

Background/Aims: Although coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, the implication of pre-existing liver disease on the outcome of COVID-19 remains unresolved.<br/>Methods: A total of 1,005 patients who were admitted to five tertiary hospitals in South Korea with laboratory-confirmed COVID-19 were included in this study. Clinical outcomes in COVID-19 patients with coexisting liver disease as well as the predictors of disease severity and mortality of COVID-19 were assessed.<br/>Results: Of the 47 patients (4.7%) who had liver-related comorbidities, 14 patients (1.4%) had liver cirrhosis. Liver cirrhosis was more common in COVID-19 patients with severe pneumonia than in those with non-severe pneumonia (4.5% vs. 0.9%, <i>P</i>=0.006). Compared to patients without liver cirrhosis, a higher proportion of patients with liver cirrhosis required oxygen therapy; were admitted to the intensive care unit; had septic shock, acute respiratory distress syndrome, or acute kidney injury; and died (<i>P</i><0.05). The overall survival rate was significantly lower in patients with liver cirrhosis than in those without liver cirrhosis (log-rank test, <i>P</i>=0.003). Along with old age and diabetes, the presence of liver cirrhosis was found to be an independent predictor of severe disease (odds ratio, 4.52; 95% confidence interval [CI], 1.20–17.02;<i>P</i>=0.026) and death (hazard ratio, 2.86; 95% CI, 1.04–9.30; <i>P</i>=0.042) in COVID-19 patients.<br/>Conclusions: This study suggests liver cirrhosis is a significant risk factor for COVID-19. Stronger personal protection and more intensive treatment for COVID-19 are recommended in these patients.

COVID‐19 in hospitalized liver transplant recipients: An early systematic review and meta‐analysis

“…The observed finding can also be explained because of the increasing age and age‐related morbidity, which were implicated as important attributes for increased case fatality of 18.7% for patients between 60 and 69 years of age and of 35.8% for patients of 70 and 79 years of age 47 . The mortality was lower than reported among cirrhotic liver disease patients with COVID‐19, for whom outlined mortality was 26%‐40%; this strongly correlated with a higher Child‐Pugh class and a higher MELD score 8,36,48‐51 …”

“…47 The mortality was lower than reported among cirrhotic liver disease patients with COVID-19, for whom outlined mortality was 26%-40%; this strongly correlated with a higher Child-Pugh class and a higher MELD score. 8,36,[48][49][50][51] The current meta-analysis included twelve studies with a relatively high number of hospitalized liver transplant patients with COVID-19 from diverse geographical regions. The most commonly outlined symptoms among the hospitalized liver transplant cohort with COVID-19 were fever (71%), cough (62%), dyspnea (48%), and gastrointestinal symptoms (28%).…”

A narrative review on characterization of acute respiratory distress syndrome in COVID-19-infected lungs using artificial intelligence

“…These comorbidities play a vital role in segregating AI models that can be independently trained for effective diagnosis and COVID-19 severity prediction. The selected comorbidity studies [ 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 ] were taken from https://pubmed.ncbi.nlm.nih.gov/ . Figure 5 shows the number of subjects with comorbidities enrolled in the ARDS-based studies.…”

COVID-19 With Preexisting Hypercoagulability Digestive Disease

“…Bajaj et al ( 40 ) also indicated that cirrhosis COVID-19 patients needed a higher BiPAP/ventilation. A multicenter study from South Korea demonstrated that the incidence of ARDS was higher in cirrhosis COVID-19 patients ( 41 ). Therefore, a close monitoring of coagulation function and diagnostic imaging for VTE should be early implemented in COVID-19 patients with preexisting cirrhosis.…”