Table 2.
Multivariable∗ Cox proportional hazards model for major outcomes among hospitalized patients with chronic liver disease and a positive test for SARS-CoV-2.
| Clinical predictors | All-cause of mortality | Mechanical ventilation | Vasopressors | |||
|---|---|---|---|---|---|---|
| Multivariable HR (95% CI) | P value | Multivariable HR (95% CI) | P value | Multivariable HR (95% CI) | P value | |
| Age in years | 1.05 (1.04–1.07) | <0.001 | 1.00 (1.00–1.06) | 0.03 | 0.99 (0.98–1.01) | 0.35 |
|
| ||||||
| Sex | ||||||
| Female | Reference | 0.45 | Reference | 0.43 | Reference | 0.47 |
| Male | 1.13 (0.82–1.55) | 1.11 (0.86–1.43) | 1.10 (0.84–1.42) | |||
|
| ||||||
| Etiology | ||||||
| ALD | 2.75 (0.64–11.85) | 0.17 | 2.79 (1.00–8.02) | 0.05 | 2.27 (0.67–7.61) | 0.18 |
| NAFLD | 0.21 (0.07–0.65) | 0.006 | 0.54 (0.31–0.93) | 0.02 | 0.66 (0.39–1.14) | 0.14 |
| Viral hepatitis | 0.22 (0.09–0.50) | <0.001 | 0.49 (0.32–0.74) | 0.001 | 0.56 (0.37–0.85) | 0.007 |
| Other liver diseases | 0.36 (0.08–1.56) | 0.17 | 0.36 (0.12–1.03) | 0.06 | 0.44 (0.13–1.48) | 0.19 |
|
| ||||||
| Cirrhosis | ||||||
| No cirrhosis | Reference | Reference | Reference | |||
| CC | 1.01 (0.13–8.15) | 0.99 | 0.47 (0.10–2.17) | 0.32 | 0.45 (0.10–2.08) | 0.31 |
| DC | 2.94 (1.23–7.06) | 0.02 | 1.51 (0.96–2.33) | 0.07 | 1.45 (0.93–2.29) | 0.11 |
|
| ||||||
| Comorbidities | ||||||
| CHF | 1.13 (0.80–1.60) | 0.48 | 1.75 (0.56–1.00) | 0.05 | 0.78 (0.58–1.06) | 0.11 |
| HT | 0.75 (0.48–1.17) | 0.21 | 0.80 (0.56–1.13) | 0.21 | 0.83 (0.57–1.21) | 0.34 |
| CKD | 1.26 (0.87–1.82) | 0.22 | 1.03 (0.77–1.38) | 0.83 | 1.00 (0.74–1.35) | 0.98 |
| Diabetes | 0.92 (0.65–1.31) | 0.64 | 1.29 (0.98–1.70) | 0.07 | 1.29 (0.96–1.73) | 0.09 |
| Chronic pulmonary disease | 1.29 (0.92–1.83) | 0.13 | 1.22 (0.93–1.62) | 0.15 | 1.42 (1.07–1.91) | 0.01 |
| Chronic neurological disease | 1.22 (0.88–1.71) | 0.23 | 0.81 (0.60–1.08) | 0.15 | 0.76 (0.56–1.03) | 0.07 |
| Primary malignancy | 0.91 (0.62–1.33) | 0.61 | 0.98 (0.68–1.42) | 0.93 | 0.89 (0.61–1.32) | 0.56 |
| Metastatic malignancy | 1.28 (0.84–1.96) | 0.26 | 0.81 (0.51–1.27) | 0.35 | 1.35 (1.01–1.59) | 0.04 |
| ALT | 1.00 (1.00–1.00) | 0.69 | 1.00 (0.99–1.00) | 0.83 | 1.00 (1.00–1.00) | 0.57 |
| AST | 1.00 (1.00–1.00) | 0.43 | 1.00 (1.00–1.00) | 0.53 | 1.00 (1.00–1.00) | 0.85 |
| ALP | 1.02 (1.00–1.04) | <0.001 | 1.00 (1.00–1.01) | 0.04 | 1.00 (1.00–1.01) | <0.001 |
| T. Bil | 1.25 (1.15–1.37) | <0.001 | 0.95 (0.76–1.18) | 0.64 | 1.04 (0.89–1.20) | 0.64 |
| PT | 1.04 (1.01–1.07) | 0.007 | 0.02 (0.99–1.05) | 0.19 | 1.03 (1.00–1.06) | 0.07 |
| INR | 1.26 (1.01–1.57) | 0.04 | 1.11 (0.88–1.39) | 0.39 | 1.13 (1.09–1.42) | 0.29 |
| Neutrophil | 1.00(1.00–1.00) | 0.007 | 1.00 (1.00–1.00) | 0.006 | 1.00 (1.00–1.00) | 0.002 |
| BUN | 1.01 (1.01–1.02) | 0.003 | 1.01 (1.00–1.02) | 0.03 | 1.01 (1.00–1.02) | 0.003 |
| CRP | 1.05 (1.01–1.14) | 0.008 | 1.00 (1.00–1.00) | 0.21 | 1.00 (1.00–1.00) | 0.42 |
| D-Dimer | 1.04 (1.01–1.07) | 0.02 | 0.98 (0.95–1.01) | 0.27 | 1.01 (0.98–1.04) | 0.47 |
| LDH | 1.00 (1.00–1.01) | 0.002 | 1.00 (1.00–1.00) | 0.05 | 1.00 (1.00–1.00) | 0.10 |
| Ferritin | 1.00 (0.98–1.00) | 0.14 | 1.00 (1.00–1.00) | 0.03 | 1.00 (1.00–1.00) | 0.09 |
|
| ||||||
| ALT | ||||||
| Normal, | Reference | Reference | Reference | |||
| 1-2 ULN | 0.86 (0.57–1.30) | 0.48 | 1.48 (0.95–2.30) | 0.08 | 1.34 (0.84–2.14) | 0.22 |
| >2–5 ULN | 1.47 (1.29–2.77) | 0.003 | 1.11 (0.73–1.70) | 0.62 | 1.04 (0.66–1.63) | 0.87 |
| >5 ULN | 1.21 (0.74–1.99) | 0.45 | 1.16 (0.73–1.84) | 0.54 | 1.14 (0.70–1.85) | 0.59 |
|
| ||||||
| AST | ||||||
| Normal, | Reference | Reference | Reference | |||
| 1-2 ULN | 0.94 (0.67–1.33) | 0.74 | 1.17 (0.89–1.53) | 0.26 | 1.32 (1.00–1.76) | 0.05 |
| >2–5 ULN | 1.92 (1.10–3.34) | 0.02 | 1.69 (1.09–2.61) | 0.01 | 1.55 (0.97–2.50) | 0.07 |
| >5 ULN | 3.62 (1.52–8.64) | 0.004 | 2.50 (1.12–5.58) | 0.02 | 2.81 (1.18–6.71) | 0.02 |
|
| ||||||
| Bilirubin | ||||||
| Normal | Reference | Reference | Reference | |||
| 1-2 ULN | 1.24 (0.70–2.23) | 0.45 | 1.19 (0.73–1.95) | 0.48 | 1.49 (0.93–2.39) | 0.09 |
| >2–5 ULN | 2.11 (0.49–9.03) | 0.31 | 0.69 (0.16–2.97) | 0.62 | 0.85 (0.20–3.67) | 0.83 |
| >5 ULN | 5.21 (0.66–40.91) | 0.12 | 0.00 (IO) | NS | 0.00 (IO) | N0 |
|
| ||||||
| ALP | ||||||
| Normal | Reference | Reference | Reference | |||
| 1-2 ULN | 1.68 (1.12–2.52) | 0.01 | 1.17 (0.84–1.65) | 0.36 | 1.28 (0.90–1.84) | 0.17 |
| >2–5 ULN | 2.29 (1.10–5.27) | 0.05 | 1.03 (0.41–2.59) | 0.94 | 1.80 (0.81–3.98) | 0.15 |
| >5 ULN | 2.15 (0.44–10.43) | 0.34 | 0.57 (0.08–4.22) | 0.58 | 1.44 (0.34–6.12) | 0.62 |
Abbreviations: HT, hypertension; CHF, congestive heart failure; CKD, chronic kidney disease; CC, compensated cirrhosis; DC, decompensated cirrhosis; NAFLD, nonalcoholic fatty liver disease; ALD, alcohol-related liver disease; ALT, alanine aminotransferases; ALP, alkaline phosphatase; GGT: γ-glutamyl transpeptidase; AST, aspartate aminotransferase; T-Bil, total bilirubin; INR, international normalized ratio; BUN, blood urea nitrogen; PT, prothrombin time; CRP, C-reactive protein; LDH, lactate dehydrogenase; HR, hazard ratio; CI, confidence interval, IO, insufficient observation. ∗Age, gender, ethnicity, race, body mass index, smoking use, etiology of liver diseases, and all the pre-existing comorbidities were adjusted as confounders in the multivariable Cox proportional hazards model.