Reductions in liver cirrhosis hospitalizations during the COVID-19 pandemic

Li, Jianglei; Liu, Deliang; Yan, Jin; Tan, Yuyong

doi:10.1007/s12072-020-10127-w

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…They also found that those admitted later in the pandemic had a higher admission MELD and shorter length of stay which they conclude is likely due to a combination of patients being encouraged to stay at home and patients avoiding hospital and therefore only presenting when more unwell. A reduction in the number of cirrhosis admissions was also seen in a tertiary Chinese centre17 during the height of lockdown (21 January 2020 to 31 March 2020) but this was a much smaller study (n=414) than Mahmud. This pattern of reduced admissions but those admitted being more unwell has been shown in patients with heart failure18 19 and those with acute coronary syndromes 20…”

Section: Discussionmentioning

confidence: 89%

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Manship

Brennan

Campbell

et al. 2022

BMJ Open Gastroenterol

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Background and aimsSARS-CoV-2 and consequent pandemic has presented unique challenges. Beyond the direct COVID-related mortality in those with liver disease, we sought to determine the effect of lockdown on people with liver disease in Scotland. The effect of lockdown on those with alcohol-related disease is of interest; and whether there were associated implications for a change in alcohol intake and consequent presentations with decompensated disease.MethodsWe performed a retrospective analysis of patients admitted to seven Scottish hospitals with a history of liver disease between 1 April and 30 April 2020 and compared across the same time in 2017, 2018 and 2019. We also repeated an intermediate assessment based on a single centre to examine for delayed effects between 1 April and 31 July 2020.ResultsWe found that results and outcomes for patients admitted in 2020 were similar to those in previous years in terms of morbidity, mortality, and length of stay. In the Scotland-wide cohort: admission MELD (Model for End-stage Liver Disease) (16 (12–22) vs 15 (12–19); p=0.141), inpatient mortality ((10.9% vs 8.6%); p=0.499) and length of stay (8 days (4–15) vs 7 days (4–13); p=0.140). In the Edinburgh cohort: admission MELD (17 (12–23) vs 17 (13–21); p=0.805), inpatient mortality ((13.7% vs 10.1%; p=0.373) and length of stay (7 days (4–14) vs 7 days (3.5–14); p=0.525)).ConclusionThis assessment of immediate and medium-term lockdown impacts on those with chronic liver disease suggested a minimal effect on the presentation of decompensated liver disease to secondary care.

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Section: Discussionmentioning

confidence: 89%

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Manship

Brennan

Campbell

et al. 2022

BMJ Open Gastroenterol

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Section: Introductionmentioning

confidence: 86%

“…2 Reports from individual US centers suggested an initial decline of acute hospitalizations for myocardial infarctions 3,4 and other conditions. 5 Trends observed among these individual facilities have been corroborated by analyses of larger health systems, indicating that some hospitals experienced a decline in non-COVID-19 hospitalizations as large as 40% during April 2020. 6 During the COVID-19 pandemic, while attention and resources focused on managing the increasing number of cases, 7 there was insufficient preparation for patient displacement caused by the overwhelming surge.…”

Section: Introductionmentioning

confidence: 86%

Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease

Yoo,

Guterman,

Hwang

et al. 2023

The Neurohospitalist

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Background and Objective: The initial months of the Corona Virus 2019 (COVID-19) pandemic resulted in decreased hospitalizations. We aimed to describe differences in hospitalizations and related procedures across neurologic disease. Methods: In our retrospective observational study using the California State Inpatient Database and state-wide population-level estimates, we calculated neurologic hospitalization rates for a control period from January 2019 to February 2020 and a COVID-19 pandemic period from March to December 2020. We calculated incident rate ratios (IRR) for neurologic hospitalizations using negative binomial regression and compared relevant procedure rates over time. Results: Population-based neurologic hospitalization rates were 29.1 per 100,000 (95% CI 26.9–31.3) in April 2020 compared to 43.6 per 100,000 (95% CI 40.4–46.7) in January 2020. Overall, the pandemic period had 13% lower incidence of neurologic hospitalizations per month (IRR 0.87, 95% CI 0.86-0.89). The smallest decreases were in neurotrauma (IRR 0.92, 95% CI 0.89–0.95) and neuro-oncologic cases (IRR 0.93, 95% CI 0.87–0.99). Headache admissions experienced the greatest decline (IRR 0.62, 95% CI 0.58–0.66). For ischemic stroke, greater rates of endovascular thrombectomy (5.6% vs 5.0%; P < .001) were observed in the pandemic. Among all neurologic disease, greater rates of gastrostomy (4.0% vs 3.5%; P < .001), intubation/mechanical ventilation (14.3% vs 12.9%, P < .001), and tracheostomy (1.4 vs 1.2%; P < .001) were observed during the pandemic. Conclusions: During the first months of the COVID-19 pandemic there were fewer hospitalizations to varying degrees for all neurologic diagnoses. Rates of procedures indicating severe disease increased. Further study is needed to determine the impact on triage, patient outcomes, and cost consequences.

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“…Finally, as testified by the drastic reduction in hospitalization for cirrhosis following the onset of the pandemic, delays in both follow-up and treatment have occurred, leading to more frequent and advanced cirrhosis-related complications. For example, acute variceal hemorrhage developed in patients who had not undergone timely endoscopic surveillance, whereas postponed routine elective paracentesis for tense ascites was converted into one requiring emergency hospitalization [ 141 ]. Therefore, the recognition that patients with cirrhosis are particularly vulnerable to the severe complications of COVID-19 is paramount.…”

Section: Covid-19 In Patients With Pre-existing Chronic Liver Diseasementioning

confidence: 99%

COVID-19: Has the Liver Been Spared?

Brandi

Spinelli

Granito

et al. 2023

IJMS

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The liver is a secondary and often collateral target of COVID-19 disease but can lead to important consequences. COVID-19 might directly cause a high number of complications in patients with pre-existing chronic liver disease, increasing their risk of hepatic decompensation. Moreover, it also determines indirect consequences in the management of patients with liver disease, especially in those suffering from decompensated cirrhosis and HCC, as well as in the execution of their follow-up and the availability of all therapeutic possibilities. Liver imaging in COVID-19 patients proved to be highly nonspecific, but it can still be useful for identifying the complications that derive from the infection. Moreover, the recent implementation of telemedicine constitutes a possible solution to both the physical distancing and the re-organizational difficulties arising from the pandemic. The present review aims to encompass the currently hypothesized pathophysiological mechanisms of liver injury in patients with COVID-19 mediated by both the direct invasion of the virus and its indirect effects and analyze the consequence of the pandemic in patients with chronic liver disease and liver tumors, with particular regard to the management strategies that have been implemented to face this worldwide emergency and that can be further improved.

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Reductions in liver cirrhosis hospitalizations during the COVID-19 pandemic

Cited by 4 publications

References 5 publications

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Impact of the COVID-19 Pandemic on Inpatient Utilization for Acute Neurologic Disease

COVID-19: Has the Liver Been Spared?

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