Impact of COVID-19 on Patients with Decompensated Liver Cirrhosis
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Variables
2.3. Ethical Approval
2.4. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics of the Patients
3.2. COVID-19 Assessment
3.3. Impact of COVID-19 on Patients with LC
3.4. Overall and COVID-19-Specific Mortality
4. Discussions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | Subjects with SARS-CoV-2 Infection n = 45 | Subjects without SARS-CoV-2 Infection n = 100 | p-Value |
---|---|---|---|
Age (years), mean values | 62.26 ± 9.56 | 60.52 ± 10.55 | 0.3462 |
Gender (%) | |||
Female | 28.9% (13) | 24% (24) | 0.6743 |
Male | 71.1% (32) | 76% (76) | 0.7305 |
MELD score, mean values | 20.62 ± 8.46 | 18.28 ± 7.59 | 0.0997 |
Liver cirrhosis etiology (%) | |||
ALD | 57.8% (26) | 56% (56) | 0.9831 |
HCV | 24.4% (11) | 16% (16) | 0.3311 |
HBV | 2.2% (1) | 10% (10) | 0.1927 |
Others | 15.6% (7) | 18% (18) | 0.9074 |
Child–Pugh class | |||
Class A | 6.7% (3) | 21% (21) | 0.0572 |
Class B | 28.9% (13) | 33% (33) | 0.7658 |
Class C | 64.4% (29) | 46% (46) | 0.0613 |
AST (UI/L), median values | 68 [19–1293] | 63.5 [17–3529] | 0.5011 |
ALT (UI/L), median values | 34 [10–354] | 37 [9–1669] | 0.6395 |
Parameter (Median Values) | Subjects with Pulmonary Injury n = 20 | Subjects without Pulmonary Injury n = 25 | p-Value |
---|---|---|---|
Length of hospitalization (days) | 13 [1–24] | 7 [1–34] | 0.0159 |
CRP (mg/L) | 56 [5.6–268] | 39.4 [0.5–222.4] | 0.3501 |
AST (IU/L) | 52 [30–1293] | 97.5 [19–300] | 0.5093 |
ALT (IU/L) | 30 [10–81] | 47 [14–354] | 0.1925 |
Lactate dehydrogenase (U/L) | 259.5 [145–4115] | 283 [243–1247] | 0.4141 |
D-dimer (mg/L) | 1201 [94–9289] | 2681 [2354–4214] | 0.0419 |
GGT | 98 [19–776] | 188 [29–470] | 0.4182 |
ALP | 101 [40–271] | 93 [69–244] | 0.8981 |
Parameter | Subjects with SARS-CoV-2 Infection n = 45 | Subjects without SARS-CoV-2 Infection n = 100 | p-Value |
---|---|---|---|
No ACLF | 51.1% (23) | 70% (70) | 0.0446 |
ACLF
| 48.9% (22) 63.6% (14) 27.3% (6) 9.1% (2) | 30% (30) 76.7% (23) 23.3% (7) 0% | 0.0446 0.4070 0.3509 0.1804 |
CLIF C-OF, median values | 7 [1–12] | 5 [5–10] | <0.0001 |
CLIF C-ACLF, median values | 47.22 [29.6–60.61] | 43.09 [27.7–53.51] | 0.0667 |
CLIF C-AD, median values | 54.97 [37.63–71.69] | 52.83 [37.02–80.2] | 0.6122 |
Associated infection (%) | 60% (27) | 33% (33) | 0.0041 |
Overall mortality (%) | 46.7% (21) | 15% (15) | 0.0001 |
Mortality in subjects without ACLF | 39.1% (9/23) | 12.9% (9/70) | 0.0141 |
Mortality in subjects with ACLF | 54.5% (12/22) | 20% (6/30) | 0.0221 |
Baseline Parameters | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
Subjects with ACLF n = 52 | Subjects without ACLF n = 93 | |||||
HR (95% CI) | p-Value | HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Pulmonary injury | 1.403 (1.162–2.389) | p < 0.0001 | 1.694 (1.057–2.134) | p < 0.0001 | 1.134 (1.017–1.644) | p = 0.0017 |
The presence of COVID-19 infection | 1.603 (1.362–1.935) | p < 0.001 | ||||
Other associated infections | 1.203 (1.002–2.275) | p < 0.001 | ||||
Child–Pugh score | 1.463 (1.042–2.015) | p = 0.012 | 1.294 (1.035–2.044) | p = 0.012 | ||
MELD score | 4.903 (2.002–9.275) | p = 0.004 | 1.654 (1.027–2.131) | p = 0.004 | ||
ACLF grade | 1.463 (1.672–2.765) | p = 0.017 | ||||
CLIF-OF score | 7.203 (2.342–12.272) | p < 0.001 | ||||
CLIF C-ACLF | 3.303 (1.892–5.075) | p = 0.003 | 1.914 (1.001–2.387) | p = 0.003 | ||
CLIF C-AD score | 1.704 (1.442–2.934) | p < 0.001 | 1.443 (1.184–1.759) | p = 0.0004 |
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Moga, T.V.; Foncea, C.; Bende, R.; Popescu, A.; Burdan, A.; Heredea, D.; Danilă, M.; Miutescu, B.; Ratiu, I.; Bizerea-Moga, T.O.; et al. Impact of COVID-19 on Patients with Decompensated Liver Cirrhosis. Diagnostics 2023, 13, 600. https://doi.org/10.3390/diagnostics13040600
Moga TV, Foncea C, Bende R, Popescu A, Burdan A, Heredea D, Danilă M, Miutescu B, Ratiu I, Bizerea-Moga TO, et al. Impact of COVID-19 on Patients with Decompensated Liver Cirrhosis. Diagnostics. 2023; 13(4):600. https://doi.org/10.3390/diagnostics13040600
Chicago/Turabian StyleMoga, Tudor Voicu, Camelia Foncea, Renata Bende, Alina Popescu, Adrian Burdan, Darius Heredea, Mirela Danilă, Bogdan Miutescu, Iulia Ratiu, Teofana Otilia Bizerea-Moga, and et al. 2023. "Impact of COVID-19 on Patients with Decompensated Liver Cirrhosis" Diagnostics 13, no. 4: 600. https://doi.org/10.3390/diagnostics13040600
APA StyleMoga, T. V., Foncea, C., Bende, R., Popescu, A., Burdan, A., Heredea, D., Danilă, M., Miutescu, B., Ratiu, I., Bizerea-Moga, T. O., Sporea, I., & Sirli, R. (2023). Impact of COVID-19 on Patients with Decompensated Liver Cirrhosis. Diagnostics, 13(4), 600. https://doi.org/10.3390/diagnostics13040600