In a North American multicenter cohort study, researchers found that people with cirrhosis and COVID-19 were similarly likely to die when compared with those with cirrhosis alone. On the other hand, they were more likely to die compared with individuals with COVID-19 alone. These results were published in the journal Gut.

“In patients with COVID-19, underlying cirrhosis should be considered a high-risk comorbid condition,” study author Jasmohan Bajaj, MD, of the Virginia Commonwealth University Health System, Richmond, and his colleagues, wrote.

Globally, COVID-19 mortality is observed to be higher in people with comorbidities, including high blood pressure, diabetes and cardiovascular disease. Cirrhosis, a form of advanced fibrosis, or scarring, seen in people with liver diseases such as hepatitis B or C, is one such comorbidity. Its impact on COVID-19 mortality rates is unknown.

In order to assess whether people with both COVID-19 and liver cirrhosis have a poorer prognosis than people with one of the two conditions alone, the research team compared outcomes among individuals with both versus either condition.

The researchers carried out a multicenter cohort study in the United States and Canada, analyzing information on patients with either cirrhosis or COVID-19 who had nonelective hospital admissions at seven centers between March 23, 2020, and May 21, 2020. A total of 37 patients had both cirrhosis and COVID-19, 127 had only cirrhosis and 108 had only COVID-19. The participants were age and gender matched.

The researchers found that people with both cirrhosis and COVID-19 had a worse prognosis than those with COVID-19 alone. However, people with both conditions were not significantly worse off than those with cirrhosis alone.

The group with both conditions had a 30% death or hospice rate compared with 20% for the group with only cirrhosis and 13% for the group with only COVID-19. The difference between the first two groups was not statistically significant, meaning it could have been due to chance, while the difference between the first and third group was significant.

The researchers noticed that patients with both conditions were more likely to experience complications arising from COVID-19 than from cirrhosis. Moreover, people with both diseases were less likely to develop gastrointestinal symptoms compared with individuals with only the coronavirus infection.

“We conclude in this multicenter study that patients hospitalized with COVID-19 in the setting of cirrhosis have an inpatient mortality rate that is similar to that of patients admitted due to  cirrhosis alone but higher than those admitted with COVID-19 without cirrhosis,” the authors wrote. “Thus, it is important to recognize that hospitalized patients with cirrhosis are inherently at high risk of mortality independent of COVID-19.”

Click here to read the study in Gut.

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