Table 1.
Comparison of Patients with S-ACLF and Patients with COVID-19 and without ACLF.
| Parameters | S-ACLF (n-20) | Non-ACLF (n-37) | P value |
|---|---|---|---|
| Age (years) | 48.4 ± 10.9 | 53 ± 12.3 | 0.174 |
| Male (n, %) | 19 (95) | 32 (86) | 0.318 |
| Comorbidities (n, %) | |||
| Diabetes mellitus | 2 (10) | 19 (51) | 0.002 |
| Hypertension | 2 (10) | 12 (32) | 0.060 |
| Coronary artery disease | 1 (5) | 3 (8) | 0.661 |
| Etiology of cirrhosis (n, %) | |||
| Alcohol | 13 (65) | 12 (32.4) | 0.094 |
| Cryptogenic | 3 (15) | 6 (16.2) | |
| Nonalcoholic steatohepatitis | 1 (5) | 12 (32.4) | |
| Viral | 2 (10) | 5 (13.5) | |
| Autoimmune | 1 (5) | 2 (5.5) | |
| Compensated cirrhosisa (n, %) | 10 (50) | 20 (54) | 0.770 |
| Severity of cirrhosis | |||
| Child Pugh score, A/B/C (%) | 11 ± 1.7, 0/25/75 | 8 ± 2.4,29.7/40.6/29.7 | <0.001 |
| Sodium MELD | 28.4 ± 7.5 | 15.2 ± 8.7 | <0.001 |
| Acute hepatic decompensation (%) | |||
| Ascites/hepatic encephalopathy/variceal bleed | 70/50/5 | 40/8/2 | 0.002/<0.001/0.065 |
| ACLF severity scores | |||
| CLIF C ACLF score | 48 ± 8.6 | ||
| ACLF CLIF C organ failure score | 10 ± 1.9 | ||
| ACLF grade – 1/2/3 (%) | 15/50/35 | ||
| COVID-19 severity grade (%) | |||
| Mild (no hypoxia)/moderate (SpO2 90–94%)/severe (SpO2<90%) on room air | 45/30/25 | 54/33/3 | 0.030 |
| Laboratory parameters | |||
| Hemoglobin (g/dL) | 9.1 ± 1.8 | 10.4 ± 2.2 | 0.031 |
| Total leukocyte count/μL | 9.9 ± 9.2 | 6 ± 3.7 | 0.028 |
| Lymphocytopenia, <1000/μL (n, %) | 4 (20) | 18 (48.6) | 0.034 |
| Platelets/μLa103 | 1.1 ± 0.4 | 1.2 ± 0.8 | 0.756 |
| Sodium (meq/l) | 130.8 ± 5.6 | 132.8 ± 4.8 | 0.169 |
| Creatinine (mg/dl) | 1.5 ± 1 | 1 ± 0.3 | 0.003 |
| Total/direct bilirubin(mg/dL) | 14.9 ± 10.6/7.6 ± 6.6 | 2.9 ± 2.4/1.3 ± 1.5 | <0.001 |
| Aspartate transaminase (<40 U/L) | 173 ± 204 | 109 ± 171 | 0.212 |
| Alanine transaminase (<40 U/L) | 73.6 ± 77.8 | 57 ± 66.5 | 0.402 |
| Alkaline phosphatase (30–120 U/L) | 141.5 ± 65.2 | 114 ± 56.5 | 0.103 |
| Total protein (g/dL) | 6 ± 1 | 6.5 ± 0.7 | 0.048 |
| Serum albumin (g/dL) | 2.7 ± 0.4 | 3 ± 0.5 | 0.082 |
| International normalized ratio | 2.5 ± 1.3 | 1.5 ± 0.6 | <0.001 |
| Inflammatory biomarkers (reference range) | |||
| Interleukin-6 (pg/ml, <7) | 64.5 ± 97.6 | 49.5 ± 89 | 0.558 |
| D-dimer (ng/ml, <232) | 2534.4 ± 2019.7 | 1406.4 ± 1688 | 0.029 |
| C-reactive protein (mg/l, <6) | 17.8 ± 25.9 | 15.9 ± 27.6 | 0.809 |
| Lactate dehydrogenase (U/L,225–450) | 523.4 ± 463.5 | 405.4 ± 417.1 | 0.331 |
| Ferritin(ng/ml,30–400) | 906.6 ± 1262.5 | 560.7 ± 1227.2 | 0.319 |
| Hospital admission (n, %) | 16 (80) | 22 (59) | 0.116 |
| Intensive care unit | 9 (45) | 4 (11) | 0.003 |
| Oxygen requirement | 11 (55) | 13 (65) | 0.147 |
| Mechanical ventilation | 7 (35) | 1 (2) | 0.001 |
| COVID-19 treatment | |||
| Supportive | 4 (20) | 12 (32) | |
| Remdesivir | 6 (30) | 14 (38) | 0.130 |
| Doxycycline | 10 (50) | 11 (30) | 0.554 |
| Steroids | 13 (65) | 16 (43) | 0.114 |
| Length of hospital stay (days) | 14.7 ± 17.3 | 5.4 ± 5.3 | 0.004 |
| Mortality (n, %) | 6 (30) | 2 (5) | 0.011 |
All results are expressed in mean ± standard deviation unless otherwise specified. ACLF, acute-on-chronic liver failure; MELD, Model for End-Stage Liver Disease; CLIF C, Chronic Liver Failure Consortium; COVID-19, coronavirus disease 2019; SpO2, oxygen saturation in pulse oximeter.
Bold describes the Significant values.
a
Before the onset of COVID-19 illness.