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. 2022 Jan 3;14(1):e20891. doi: 10.7759/cureus.20891

Table 5. Studies during the first wave of the COVID-19 pandemic predicting the outcome of CWC patients.

CWC: cirrhosis with COVID-19; COVID-19: coronavirus disease 2019; CCI: Charlson Comorbidity Index; ACLF: acute on chronic liver failure; CLD: chronic liver disease; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; AST: aspartate transaminase; ALT: alanine transaminase; OR: odds ratio; CI: confidence interval; HR: hazard ratio

Authors Study population Major findings
Bajaj et al. [14] 37 patients with cirrhosis plus COVID-19 were matched with 108 patients with COVID-19 and 127 patients with cirrhosis Patients with cirrhosis plus COVID-19 had higher mortality compared with patients with COVID-19 (30% vs. 13%, p = 0.03) but not between patients with cirrhosis plus COVID-19 and patients with cirrhosis (30% vs. 20%, p = 0.16). In the entire group, CCI (OR = 1.23, 95% CI = 1.11-1.37; p < 0.0001) was the only variable predictive of mortality on multivariable regression
Shalimar et al. [19] 28 COVID-19 patients with cirrhosis The mortality rate in COVID-19 patients was 42.3% (11/26) compared to 23.1% (18/78) in the historical controls (p = 0.077). All COVID-19 patients with ACLF (9/9) died compared to 53.3% (16/30) in ACLF patients in the historical control group (p = 0.015). Requirement of mechanical ventilation independently predicted mortality (HR = 13.68)
Marjot et al. [20] 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) Mortality was 32% in patients with cirrhosis compared to 8% in those without (p < 0.001). Factors associated with death in the total CLD cohort were age (OR = 1.02; 1.01–1.04), Child-Pugh A (OR = 1.90; 1.03–3.52), B (OR = 4.14; 2.4–7.65), or C (OR = 9.32; 4.80–18.08) cirrhosis, and alcohol-related liver disease (OR = 1.79; 1.03–3.13)
Sarin et al. [24] 228 patients (185 CLD without cirrhosis and 43 with cirrhosis) Liver-related complications increased (p < 0.05) with stage of liver disease. CTP score of 9 or more at presentation predicted high mortality. Rising bilirubin and AST/ALT ratio predicted mortality among cirrhosis patients
Kim et al. [26] 867 patients with CLD plus COVID-19 The overall all-cause mortality was 14.0% (n = 121), and 61.7% (n = 535) had severe COVID-19. Liver-specific factors associated with independent risk of higher overall mortality included ALD (HR = 2.42, 95% CI = 1.29–4.55), decompensated cirrhosis (HR = 2.91, 95% CI = 1.70–5.00), and HCC (HR = 3.31, 95% CI = 1.53–7.16]. Other factors included increasing age, diabetes, hypertension, chronic obstructive pulmonary disease, and current smoker
Wang et al. [28] 1,034,270 patients with CLD, 16,530 with COVID-19, and 820 with both COVID-19 and CLD Patients with CLD were at a significantly increased risk for COVID-19 compared with patients without CLD. African Americans with CLD were twice more likely to develop COVID-19 than Caucasians. Patients with COVID-19 and a recent encounter of CLD had a death rate of 10.3% versus 5.5% among COVID-19 patients without CLD (p < 0.001) and a hospitalization rate of 41.0% versus 23.9% among COVID-19 patients without CLD (p < 0.001)