Please use this identifier to cite or link to this item:
Title: Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study
Authors: Marjot, Thomas
Moon, Andrew M.
Cook, Jonathan A.
Abd-Elsalam, Sherief
Aloman, Costica
Armstrong, Matthew J.
Pose, Elisa
Brenner, Erica J.
Cargill, Tamsin
Catana, Maria-Andreea
Dhanasekaran, Renumathy
Eshraghian, Ahad
García-Juárez, I.
Gill, Upkar S.
Jones, Patricia D.
Kennedy, James
Marshall, Aileen
Matthews, Charmaine
Mells, George
Mercer, Carolyn
Perumalswami, Ponni, V
Avitabile, Emma
Qi, Xialong
Su, Feng
Ufere, Nneka N.
Wong, Yu Jun 
Zheng, Ming-Hua
Barnes, Eleanor
Barritt, Alfred S.
Webb, Gwilym J.
Keywords: Acute-on-chronic liver failure
Chronic liver disease
Issue Date: 1-Mar-2021
Publisher: Elsevier B.V.
Citation: Marjot, Thomas, Moon, Andrew M., Cook, Jonathan A., Abd-Elsalam, Sherief, Aloman, Costica, Armstrong, Matthew J., Pose, Elisa, Brenner, Erica J., Cargill, Tamsin, Catana, Maria-Andreea, Dhanasekaran, Renumathy, Eshraghian, Ahad, García-Juárez, I., Gill, Upkar S., Jones, Patricia D., Kennedy, James, Marshall, Aileen, Matthews, Charmaine, Mells, George, Mercer, Carolyn, Perumalswami, Ponni, V, Avitabile, Emma, Qi, Xialong, Su, Feng, Ufere, Nneka N., Wong, Yu Jun, Zheng, Ming-Hua, Barnes, Eleanor, Barritt, Alfred S., Webb, Gwilym J. (2021-03-01). Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study. Journal of Hepatology 74 (3) : 567-577. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background & Aims: Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation, leading to concerns that affected patients may be at risk of adverse outcomes following SARS-CoV-2 infection. We aimed to determine the impact of COVID-19 on patients with pre-existing liver disease, which currently remains ill-defined. Methods: Between 25th March and 8th July 2020, data on 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) were collected by 2 international registries and compared to data on non-CLD patients with SARS-CoV-2 from a UK hospital network. Results: Mortality was 32% in patients with cirrhosis compared to 8% in those without (p <0.001). Mortality in patients with cirrhosis increased according to Child-Pugh class (A [19%], B [35%], C [51%]) and the main cause of death was from respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (odds ratio [OR] 1.02; 1.01–1.04), Child-Pugh A (OR 1.90; 1.03–3.52), B (OR 4.14; 2.4–7.65), or C (OR 9.32; 4.80–18.08) cirrhosis and alcohol-related liver disease (OR 1.79; 1.03–3.13). Compared to patients without CLD (n = 620), propensity-score-matched analysis revealed significant increases in mortality in those with Child-Pugh B (+20.0% [8.8%–31.3%]) and C (+38.1% [27.1%–49.2%]) cirrhosis. Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of whom 21% had no respiratory symptoms. Half of those with hepatic decompensation had acute-on-chronic liver failure. Conclusions: In the largest such cohort to date, we demonstrate that baseline liver disease stage and alcohol-related liver disease are independent risk factors for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic. Lay summary: This international registry study demonstrates that patients with cirrhosis are at increased risk of death from COVID-19. Mortality from COVID-19 was particularly high among patients with more advanced cirrhosis and those with alcohol-related liver disease. © 2020 European Association for the Study of the Liver
Source Title: Journal of Hepatology
ISSN: 0168-8278
DOI: 10.1016/j.jhep.2020.09.024
Rights: Attribution 4.0 International
Appears in Collections:Elements
Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_1016_j_jhep_2020_09_024.pdf780.19 kBAdobe PDF



Google ScholarTM



This item is licensed under a Creative Commons License Creative Commons