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10.1016/j.jhep.2020.06.001

http://scihub22266oqcxt.onion/10.1016/j.jhep.2020.06.001
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suck abstract from ncbi


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pmid32526252      J+Hepatol 2020 ; 73 (5): 1063-1071
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  • High rates of 30-day mortality in patients with cirrhosis and COVID-19 #MMPMID32526252
  • Iavarone M; D'Ambrosio R; Soria A; Triolo M; Pugliese N; Del Poggio P; Perricone G; Massironi S; Spinetti A; Buscarini E; Vigano M; Carriero C; Fagiuoli S; Aghemo A; Belli LS; Luca M; Pedaci M; Rimondi A; Rumi MG; Invernizzi P; Bonfanti P; Lampertico P
  • J Hepatol 2020[Nov]; 73 (5): 1063-1071 PMID32526252show ga
  • BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) poses a major health threat to healthy individuals and those with comorbidities, but its impact on patients with cirrhosis is currently unknown. Herein, we aimed to evaluate the impact of COVID-19 on the clinical outcome of patients with cirrhosis. METHODS: In this multicentre retrospective study, patients with cirrhosis and a confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were enrolled between 1(st) and 31(th) March 2020. Clinical and biochemical data at diagnosis of COVID-19 and at the last outpatient visit were obtained through review of medical records. RESULTS: Fifty patients with cirrhosis and confirmed SARS-CoV-2 infection were enrolled (age 67 years, 70% men, 38% virus-related, 52% previously compensated cirrhosis). At diagnosis, 64% of patients presented fever, 42% shortness of breath/polypnea, 22% encephalopathy, 96% needed hospitalization or a prolonged stay if already in hospital. Respiratory support was necessary in 71%, 52% received antivirals, 80% heparin. Serum albumin significantly decreased, while bilirubin, creatinine and prothrombin time significantly increased at COVID-19 diagnosis compared to last available data. The proportion of patients with a model for end-stage liver disease (MELD) score >/=15 increased from 13% to 26% (p = 0.037), acute-on-chronic liver failure and de novo acute liver injury occurred in 14 (28%) and 10 patients, respectively. Seventeen patients died after a median of 10 (4-13) days from COVID-19 diagnosis, with a 30-day-mortality rate of 34%. The severity of lung and liver (according to CLIF-C, CLIF-OF and MELD scores) diseases independently predicted mortality. In patients with cirrhosis, mortality was significantly higher in those with COVID-19 than in those hospitalized for bacterial infections. CONCLUSION: COVID-19 is associated with liver function deterioration and elevated mortality in patients with cirrhosis. LAY SUMMARY: Coronavirus disease 2019 (COVID-19) poses a major health threat to healthy individuals and those with comorbidities. Herein, we assessed its impact on patients with cirrhosis. Infection with COVID-19 was associated with liver function deterioration and elevated mortality in patients with cirrhosis.
  • |*Coronavirus Infections/diagnosis/drug therapy/mortality/physiopathology[MESH]
  • |*Liver Cirrhosis/diagnosis/epidemiology/physiopathology[MESH]
  • |*Liver Function Tests/methods/statistics & numerical data[MESH]
  • |*Pandemics[MESH]
  • |*Pneumonia, Viral/diagnosis/drug therapy/mortality/physiopathology/virology[MESH]
  • |Aged[MESH]
  • |Antiviral Agents/administration & dosage/adverse effects[MESH]
  • |Betacoronavirus/isolation & purification[MESH]
  • |COVID-19[MESH]
  • |COVID-19 Testing[MESH]
  • |Clinical Laboratory Techniques/methods[MESH]
  • |Comorbidity[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Italy/epidemiology[MESH]
  • |Male[MESH]
  • |Mortality[MESH]
  • |Retrospective Studies[MESH]
  • |Risk Factors[MESH]


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