Table 1.

Studies on coronavirus disease-2019 outcome and mortality in patients with chronic liver disease and cirrhosis

Study	Number	Country	Pre-Existing Liver Diseases	Findings
Yadav DK, et al.,86 2020 (meta-analysis)	2115	China	4% (mostly cirrhosis and HBV)	•High prevalence of liver injury (27%) •Patients with liver injury had more severe COVID infection (OR = 2.57, P = .01), and higher mortality (OR = 1.66, P = .03) •Overall mortality in patients with COVID-19 infection with liver injury is 23.5%
Sarin SK, et al,87 2020 (The APCOLIS study)	228	13 Asian countries	185 CLD patients including 43 with cirrhosis (NAFLD in 55%, and viral hepatitis in 30%)	•Mortality in CLD patients with COVID-19 vs cirrhosis with COVID-19 (2.7% vs 16.3%, P = .002) •43% of CLD presented with acute liver injury, 20% of patients with cirrhosis presented with either ACLF (11.6%) or acute decompensation (9%) •A Child-Turcotte Pugh score ≥ 9 at presentation predicted high mortality (HR = 19.2 [95% CI 2.3–163.3], P < .001)
Mallet V, et al,68 2020	15,476 COVID-19 patients with chronic liver disease	France	Chronic liver disease (alcohol-induced 23%, HBV 5%, HCV 4.6%, HCC 4.6%, LT 2.1%)	•30-d post-COVID mortality with chronic liver disease 19% •Chronic liver disease increased risk of COVID-19–related death •Patients with alcohol use disorders, decompensated cirrhosis, or primary liver cancer had an increased risk of COVID-19-related mortality
Butt AA, et al,53 2021 (ERCHIVES database)	SARS-CoV-2 with HCV = 975 SARS-CoV-2 without HCV = 975	United States	HCV	•HCV infected persons with SARS-CoV-2 are more likely to be admitted to a hospital •Mortality was not different between those with vs without HCV infection
Verhelst X, et al,88 2021	110	Belgium	Autoimmune hepatitis	•Low COVID-19 infection rate (1.2%), survival 100%, liver decompensation 0%, hospitalization 3.5% •Supports not stopping immunosuppressive treatment during COVID-19 infection
Di Giorgio A, et al,89 2020	148	Italy	Autoimmune liver diseases (AILD)	•Confirmed cases of COVID-19 3%, survival 99%, mortality 1% •Patients with AILD were not more susceptible to COVID-19 than the general population. Tapering or withdrawal of immunosuppression was not required
Marjot T, et al,54 2021(ERN RARE-LIVER/COVID-Hep/SECURE-Cirrhosis)	932 patients with CLD and COVID-19 (70 with AIH)	International registry	Autoimmune hepatitis	•No differences in major outcomes between patients with AIH and non-AIH CLD, including hospitalization (76% vs 85%; P = .06), ICU admission (29% vs 23%; P = .240), and death (23% vs 20%; P = .64) •Factors associated with mortality within the AIH cohort included old age, and Child-Pugh class B and C cirrhosis but not use of immunosuppression
Younossi ZM, et al,90 2021	4835 patients with COVID-19 (NAFLD = 553)	United States	NAFLD	•3.9% of patients with NAFLD and COVID-19 infection experienced acute liver injury •Crude inpatient mortality in the NAFLD group was 11% •Independent predictors of mortality included higher FIB-4 and multimorbidity scores, morbid obesity, older age, and hypoxemia on admission
Kim D, et al,67 2021(The COLD study)	867 CLD = 620 (71.5%) Cirrhosis = 227 (26.2%) ALD = 94 NAFLD = 456 HBV = 62 HCV = 190 HCC = 22	US multicenter	Chronic liver disease and cirrhosis	•The overall all-cause mortality was 14% •Independent risk factors for overall mortality were 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)
Jin Ge, et al,91 2021(The National COVID Cohort Collaborative (N3C) study)	220,727 patients with CLD and known SARS-CoV-2 test status: 58% noncirrhosis/negative, 13% noncirrhosis/positive, 24% cirrhosis/negative 4% cirrhosis/positive SARS-CoV-2 test	United States	Chronic liver disease and cirrhosis	•SARS-CoV-2 infection was associated with 2.38 times hazard ratio of all-cause mortality within 30 d among patients with cirrhosis
Marjot T, et al,3 2021(SECURE -cirrhosis and COVID-Hep)	745 ALD = 179 NAFLD = 322 HBV = 96 HCV = 92 HCC = 48	International registry	Chronic liver disease and cirrhosis	•Mortality in patients with cirrhosis 32% vs mortality in chronic liver disease 8% •Mortality according to Child-Pugh classes was class A (19%), B (35%), and C (51%) •ALD was an independent risk factor for death (OR = 1.79, 95%CI 1.03–3.13) •In the CLD cohort, mortality increased following hospitalization, admission to ICU, and invasive ventilation •After adjusting for baseline characteristics, NAFLD, viral hepatitis, and HCC were not independently associated with death
Lavarone M, et al,92 2020	50	Italy	Cirrhosis	•Overall 30-d mortality was 34% •COVID-19 was associated with liver function deterioration and mortality in cirrhosis •Severity of lung and liver diseases (according to CLIF-C ACLF, CLIF-OF and MELD scores) independently predicted mortality •No major adverse events were related to thromboprophylaxis (heparin administered to 80% of patients) or antiviral treatments
Clift AK, et al,93 2020 (population-based cohort study)	11,865 patients with cirrhosis (0.2% of total cohort)	United Kingdom	Cirrhosis	•Increased hazard ratio for COVID-19-related mortality in patients with cirrhosis •Male cirrhosis (HR = 1.29, 95%CI 0.83–2.02), Female cirrhosis (HR = 1.85,95%CI 1.15–2.99)
Bajaj JS, et al,62 2021	•Patients with cirrhosis and COVID-19 (n = 37) •Patients with COVID-19 (n = 108) •Patients with cirrhosis (n = 127)	North America and Canada	Cirrhosis	•Patients with cirrhosis and COVID-19 had higher mortality compared with patients with COVID-19 (30% vs 13%, P = .03) but not between patients with COVID-19 and those with cirrhosis alone (30% vs 20%, P = .16)
Ioannou GN, et al,94 2021 (Veterans Affairs national healthcare system)	305 cirrhosis with SARS-CoV-2	United States	Cirrhosis	•SARS-CoV-2 infection was associated with a 3.5-fold increase in mortality in patients with cirrhosis •30-d mortality for patients with cirrhosis and SARS-CoV-2 infection was 18% •The most important predictors of mortality were advanced age, decompensated cirrhosis, and high MELD score

Abbreviations: AIH, autoimmune hepatitis; FIB-4, fibrosis-4; HBV, hepatitis B virus; HCV, hepatitis C virus; HR, hazard ratio; LT, liver transplant; MELD, Model for End-Stage Liver Disease.