Chronic liver diseases associated with COVID-19 mortality
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Chronic liver diseases, including decompensated cirrhosis and hepatocellular carcinoma, were associated with increased mortality in patients with COVID-19, according to study results.
“Identifying predictors of mortality will allow for risk stratification of patients with chronic liver disease affected by COVID-19 and help improve health care delivery,” Renumathy Dhanasekaran, MD, of Stanford University, and colleagues wrote. “To comprehensively characterize the clinical outcomes of COVID-19 in patients with chronic liver disease, we undertook a multicenter, observational study of patients with chronic liver disease who were diagnosed with COVID-19 in 21 centers across the United States.”
Using a cohort of 867 patients with COVID-19 and a chronic liver disease, the researchers sought to identify predictors of all-cause mortality, as well as the risk factors for severe COVID-19.
In the study cohort, all-cause mortality was 14% (n = 121), while the rate of severe COVID-19 was 61.7% (n = 535).
Researchers found that alcohol-related liver disease (HR = 2.42; 95% CI, 1.29-4.55), decompensated cirrhosis (HR = 2.91; 95% CI, 1.7-5) and HCC (HR = 3.31; 95% CI, 1.53-7.16) were associated with risk for higher overall mortality. Increasing age, diabetes, hypertension, chronic obstructive pulmonary disease and current smoking were also risk factors.
Additionally, Hispanic ethnicity (OR = 2.33; 95% CI, 1.47-3.7) and decompensated cirrhosis (OR = 2.5; 95% CI, 1.2-5.21) were independently associated with the risk for severe COVID-19.
Dhanasekaran and colleagues wrote that knowledge of COVID-19’s impact on patients with chronic liver disease is still evolving.
“These findings can be used to prospectively design protective measures for these vulnerable populations, such as continuing the emphasis on telemedicine, prioritizing them for future vaccinations, as well as actively including these patients in prospective COVID-19 surveillance studies and drug trials,” they wrote.