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10.1016/j.jhep.2020.09.024

http://scihub22266oqcxt.onion/10.1016/j.jhep.2020.09.024
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suck abstract from ncbi


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pmid33035628      J+Hepatol 2021 ; 74 (3): 567-577
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  • Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study #MMPMID33035628
  • Marjot T; Moon AM; Cook JA; Abd-Elsalam S; Aloman C; Armstrong MJ; Pose E; Brenner EJ; Cargill T; Catana MA; Dhanasekaran R; Eshraghian A; Garcia-Juarez I; Gill US; Jones PD; Kennedy J; Marshall A; Matthews C; Mells G; Mercer C; Perumalswami PV; Avitabile E; Qi X; Su F; Ufere NN; Wong YJ; Zheng MH; Barnes E; Barritt AS 4th; Webb GJ
  • J Hepatol 2021[Mar]; 74 (3): 567-577 PMID33035628show ga
  • 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.
  • |*Acute-On-Chronic Liver Failure/diagnosis/epidemiology[MESH]
  • |*COVID-19/mortality/therapy[MESH]
  • |*Liver Cirrhosis/diagnosis/epidemiology/etiology[MESH]
  • |Disease Progression[MESH]
  • |Female[MESH]
  • |Global Health/statistics & numerical data[MESH]
  • |Hospitalization/statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Liver Function Tests/methods[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Mortality[MESH]
  • |Registries/statistics & numerical data[MESH]
  • |Risk Assessment/methods[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2/isolation & purification[MESH]


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