TABLE 2.
Comparison of Sociodemographic and Clinical Characteristics Among Wait‐List Additions and LT Recipients in the USA Before and During the COVID‐19 Pandemic
| Wait‐List Additions* | LT Recipients † | |||||
|---|---|---|---|---|---|---|
| Pre‐COVID Era | COVID Era | P value | Pre‐COVID Era | COVID Era | P Value | |
| June 2019 to February 2020 (n = 9,528), (%) | April 2020 to December 2020 (n = 9,259), (%) | June 2019 to February 2020 (n = 6,325), (%) | April 2020 to December 2020 (n = 6,309), (%) | |||
| Median age [IQR] (years) | 58 [15] | 57 [16] | <0.001 | 58 [15] | 57 [16] | 0.073 |
| Gender | 0.730 | 0.969 | ||||
| Female | 3,593 (37.7) | 3,469 (37.5) | 2,321 (36.7) | 2,313 (36.7) | ||
| Male | 5,935 (62.3) | 5,790 (62.5) | 4,004 (63.3) | 3,996 (63.3) | ||
| Ethnicity/race | 0.239 | 0.085 | ||||
| Caucasian | 6,693 (70.2) | 6,382 (68.9) | 4,512 (71.3) | 4,389 (69.6) | ||
| African American | 666 (7.0) | 646 (7.0) | 447 (7.1) | 458 (7.3) | ||
| Hispanic | 1,636 (17.2) | 1,659 (17.9) | 999 (15.8) | 1,075 (17.0) | ||
| Asian | 363 (3.8) | 395 (4.3) | 237 (3.7) | 273 (4.3) | ||
| Other | 170 (1.8) | 177 (1.9) | 130 (2.1) | 114 (1.8) | ||
| Primary insurance | 0.003 | <0.001 | ||||
| Medicaid | 1,656 (17.4) | 1,692 (18.3) | 924 (14.6) | 1,040 (16.5) | ||
| Medicare | 2,642 (27.7) | 2,345 (25.3) | 1,918 (30.3) | 1,797 (28.5) | ||
| Private | 4,781 (50.2) | 4,771 (51.5) | 3,245 (51.3) | 3,171 (50.3) | ||
| All other | 449 (4.7) | 451 (4.9) | 238 (3.8) | 301 (4.8) | ||
| etiologies of liver disease | ||||||
| Chronic HCV infection | 1,476 (15.5) | 1,148 (12.4) | <0.001 | 1,174 (18.6) | 1,003 (15.9) | <0.001 |
| ALD | 3,546 (37.2) | 3,710 (40.1) | <0.001 | 2,328 (36.8) | 2,495 (39.5) | 0.002 |
| NASH | 2,311 (24.3) | 2,169 (23.4) | 0.183 | 1,491 (23.6) | 1,526 (24.2) | 0.418 |
| Laboratory MELD‐Na score | 18 [14] | 19 [15] | <0.001 | 23 [15] | 24 [15] | <0.001 |
| MELD‐Na score | <0.001 | <0.001 | ||||
| <15 | 3,304 (34.7) | 2,934 (31.7) | 1,360 (21.5) | 1,242 (19.7) | ||
| 15‐19 | 1,906 (20.0) | 1,743 (18.8) | 1,026 (16.2) | 883 (14.0) | ||
| <20 | 5,210 (54.7%) | 4,677 (50.5%) | 2,386 (37.7%) | 2,125 (33.7%) | ||
| 20‐24 | 1,511 (15.9%) | 1,478 (16.0%) | 1,047 (16.6%) | 1,039 (16.5%) | ||
| 25‐29 | 1,005 (10.5%) | 1,063 (11.5%) | 991 (15.7%) | 1,035 (16.4%) | ||
| 30‐34 | 766 (8.0%) | 867 (9.4%) | 770 (12.2%) | 948 (15.0%) | ||
| >35 | 1,036 (10.9%) | 1,174 (12.7%) | 1,131 (17.9%) | 1,162 (18.4%) | ||
| Hepatic decompensation | ||||||
| Moderate‐severe ascites | 2,601 (27.3) | 2,710 (29.3) | 0.003 | 2,049 (32.4) | 2,240 (35.5) | <0.001 |
| Spontaneous bacterial peritonitis | 895 (9.4) | 829 (9.0) | 0.296 | 642 (10.2) | 627 (9.9) | 0.692 |
| Severe HE | 880 (9.2) | 917 (9.9) | 0.120 | 785 (12.4) | 861 (13.6) | 0.039 |
| HCC | 989 (10.4) | 885 (9.6) | 0.060 | 593 (8.9) | 552 (8.7) | 0.220 |
| Hemodialysis | 901 (9.5) | 1,001 (10.8) | 0.002 | 1,047 (16.6) | 1,131 (17.9) | 0.041 |
| Mechanical ventilation/life Support | 424 (4.5) | 398 (4.3) | 0.612 | 566 (8.9) | 484 (7.7) | 0.009 |
| Location at transplant | <0.001 | |||||
| Home | ‐ | ‐ | 4,205 (66.5) | 3,870 (62.2) | ||
| Hospitalized not in ICU | ‐ | ‐ | 1,246 (19.7) | 1,457 (23.4) | ||
| ICU | ‐ | ‐ | 873 (13.8) | 897 (14.4) | ||
| US region | 0.160 | 0.525 | ||||
| Northeast | 1,142 (12.0) | 1,048 (11.3) | 591 (9.3) | 641 (10.2) | ||
| Mid‐Atlantic | 1,104 (11.6) | 1,029 (11.1) | 707 (11.2) | 666 (10.6) | ||
| Southeast | 2,186 (22.9) | 2,130 (23.0) | 1,619 (25.6) | 1,574 (24.9) | ||
| North Midwest | 2,066 (21.7) | 1,950 (21.1) | 1,525 (24.1) | 1,535 (24.3) | ||
| South Midwest | 1,203 (12.6) | 1,197 (12.9) | 679 (10.7) | 672 (10.7) | ||
| Southwest | 1,563 (16.4) | 1,648 (17.8) | 1,008 (15.9) | 1,041 (16.5) | ||
| Northwest | 264 (2.8) | 257 (2.8) | 196 (3.1) | 180 (2.9) | ||
*
Values (age, MELD‐Na, hepatic decompensation, hemodialysis, and mechanical ventilation/life support) for wait‐list additions reported at time of listing or wait‐list registration.
†
Values (age, MELD‐Na, hepatic decompensation, hemodialysis and mechanical ventilation/life support) for liver transplant recipient reported at time of transplant.
Abbreviation: IQR, interquartile range.