Cirrhotic COVID-19 survivors show poor short-term outcomes, no differences long-term
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SAN DIEGO — Patients with cirrhosis who survived COVID-19 may not have worsening of underlying disease or death in the long-term compared with cirrhotic patients who never acquired COVID-19, noted data from Digestive Disease Week 2022.
“While previous studies have focused on the clinical outcomes of COVID-19 disease in patients with cirrhosis, there has been a scarcity of data about the impact of an episode of COVID-19 on the course of underlying liver disease in cirrhotics,” Monica Chowdhry, MD, gastroenterology fellow from West Virginia University, Morgantown, told Healio.
Using TriNetX, a multi-institutional research network, Chowdhry and colleagues performed a retrospective study to identify 18,228 patients with compensated cirrhosis who were tested for COVID-19 from January 2020 to December 2020. Among these, 1,217 patients tested positive for COVID-19 and 17,011 patients tested negative and were never diagnosed for COVID-19. The risk for decompensation of cirrhosis, need for inpatient/ICU services and mortality served as primary outcomes.
Short-term outcomes in the two groups were compared at 3 months, with those who survived at 3 months followed up to 1 year to determine long-term outcomes. After propensity score matching outcomes were compared after adjusting for confounding variables including age, gender, race, diabetes, ischemic heart disease, hypertension, chronic kidney disease, chronic lower respiratory disease and nicotine dependence.
According to the researchers, at 3 months, among patients who tested positive for COVID-19 had significantly higher risk of mortality. This remained high after propensity score matching. Additionally, these patients had a higher risk for decompensation and inpatient or ICU care. At 1 year, in both the unmatched and matched analysis, follow-up did not demonstrate an increased risk of mortality, decompensation and inpatient or ICU care.
“In this first large study addressing this question, we found that while short-term outcomes are poor in patients with cirrhosis who developed COVID-19, if these patients survive the COVID episode, they are not more likely to develop new decompensation or death at 3-12 months than cirrhotics who never suffered COVID-19,” Chowdhry told Healio.
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Chowdry M, et al. Abstract 781. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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