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. 2022 May 12:10.1111/imj.15817. Online ahead of print. doi: 10.1111/imj.15817

The short‐term outcomes of patients with chronic liver disease hospitalized with COVID‐19

Ivica Grgurevic 1,2,3,, Marko Lucijanić 2,4, Frane Pastrovic 1, Mislav Barisic Jaman 1, Ida Tjesic Drinkovic 1, Marko Zelenika 1, Marko Milosevic 1, Barbara Medic 1, Dusko Kardum 1, Tomislav Bokun 1,3, Ivica Luksic 2,5, Nevenka Piskac Zivkovic 6, Tatjana Keres 7, Vlatko Grabovac 7,8, Jasminka Persec 9,10, Bruno Barsic 2,7
PMCID: PMC9348237  PMID: 35555962

Abstract

Background and aims

Patients with chronic liver disease (CLD) might have aggravated course upon acquisition of coronavirus disease 2019 (COVID‐19). We aimed to analyse the outcomes of patients with CLD who were hospitalized due to COVID‐19.

Methods

Medical records of 4014 patients hospitalized due to COVID‐19 in a regional referral hospital over a 12‐month period were analysed. Patients with CLD were identified based on discharge diagnoses according to ICD‐10 classification. Patients were followed for 30 days from admission, and their outcomes (intensive care unit (ICU) admission, mechanical ventilation (MV) or death) were analysed.

Results

Of the 4014 patients, 110 (2.7%) had CLD and 49 (1.2%) had cirrhosis. Median age of CLD patients was 67.5 years, 79 (71.8%) were males, 224 (23.5%) obese, 56 (50.9%) reported alcohol abuse, 24 (21.8%) had non‐alcoholic fatty liver disease, 11 (10%) viral hepatitis and 98 (89.1%) had pneumonia. Median length of hospitalization was 12 days, 32 (29.1%) patients required ICU admission and 23 (20.9%) MV, while 43 (39.1%) died. In univariate analysis, patients with cirrhosis (45% vs 73%, HR=2.95; P<0.001), but not those with non‐cirrhotic CLD (74% vs 73%, P>0.05), experienced worse 30‐days survival when compared to age, sex and COVID‐19 duration matched cohorts. In a logistic regression analysis conducted on the overall and matched cohorts, liver cirrhosis, but not CLD, predicted inferior survival independently of age, comorbidities and severity of COVID‐19, with a fourfold higher adjusted risk of 30‐day mortality.

Conclusion

Cirrhosis is independently associated with higher 30‐day mortality of hospitalized patients with COVID‐19.

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