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Shalimar; Elhence, Anshuman; Vaishnav, Manas; Kumar, Ramesh; Pathak, Piyush; Soni, Kapil Dev; Aggarwal, Richa; Soneja, Manish; Jorwal, Pankaj; Kumar, Arvind; Khanna, Puneet; Singh, Akhil Kant; Biswas, Ashutosh; Nischal, Neeraj; Dar, Lalit; Choudhary, Aashish; Rangarajan, Krithika; Mohan, Anant; Acharya, Pragyan; Nayak, Baibaswata; Gunjan, Deepak; Saraya, Anoop; Mahapatra, Soumya; Makharia, Govind; Trikha, Anjan; Garg, Pramod
Indian journal of gastroenterology, 06/2020, Letnik: 39, Številka: 3Journal Article
Background and Aim There is a paucity of data on the clinical presentations and outcomes of Corona Virus Disease-19 (COVID-19) in patients with underlying liver disease. We aimed to summarize the presentations and outcomes of COVID-19-positive patients and compare with historical controls. Methods Patients with known chronic liver disease who presented with superimposed COVID-19 ( n = 28) between 22 April 2020 and 22 June 2020 were studied. Seventy-eight cirrhotic patients without COVID-19 were included as historical controls for comparison. Results A total of 28 COVID-19 patients (two without cirrhosis, one with compensated cirrhosis, sixteen with acute decompensation AD, and nine with acute-on-chronic liver failure ACLF) were included. The etiology of cirrhosis was alcohol ( n = 9), non-alcoholic fatty liver disease ( n = 2), viral ( n = 5), autoimmune hepatitis ( n = 4), and cryptogenic cirrhosis ( n = 6). The clinical presentations included complications of cirrhosis in 12 (46.2%), respiratory symptoms in 3 (11.5%), and combined complications of cirrhosis and respiratory symptoms in 11 (42.3%) patients. The median hospital stay was 8 (7–12) days. The mortality rate in COVID-19 patients was 42.3% (11/26), as compared with 23.1% (18/78) in the historical controls ( p = 0.077). All COVID-19 patients with ACLF (9/9) died compared with 53.3% (16/30) in ACLF of historical controls ( p = 0.015). Mortality rate was higher in COVID-19 patients with compensated cirrhosis and AD as compared with historical controls 2/17 (11.8%) vs. 2/48 (4.2%), though not statistically significant ( p = 0.278). Requirement of mechanical ventilation independently predicted mortality (hazard ratio 13.68). Both non-cirrhotic patients presented with respiratory symptoms and recovered uneventfully. Conclusion COVID-19 is associated with poor outcomes in patients with cirrhosis, with worst survival rates in ACLF. Mechanical ventilation is associated with a poor outcome.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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