• Ivica Grgurevic, Marko Lucijanić, Frane Pastrovic, Mislav Barisic Jaman, Ida Tjesic Drinkovic, Marko Zelenika, Marko Milosevic, Barbara Medic, Dusko Kardum, Tomislav Bokun, Ivica Luksic, Nevenka Piskac Zivkovic, Tatjana Keres, Vlatko Grabovac, Jasminka Persec, and Bruno Barsic.
• Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, Zagreb, Croatia.
• Intern Med J. 2022 Nov 1; 52 (11): 189118991891-1899.

BackgroundPatients with chronic liver disease (CLD) might have an aggravated course after acquisition of coronavirus disease 2019 (COVID-19).AimsTo analyse the outcomes of patients with CLD who were hospitalised due to COVID-19.MethodsThe medical records of 4014 patients hospitalised because of COVID-19 in a regional referral hospital over a 12-month period were analysed. Patients with CLD were identified based on discharge diagnoses according to the International Classification of Diseases-10th Revision. Patients were followed for 30 days from admission and their outcomes (intensive care unit (ICU) admission, mechanical ventilation (MV) or death) were analysed.ResultsOf the 4014 patients, 110 (2.7%) had CLD and 49 (1.2%) had cirrhosis. The median age of CLD patients was 67.5 years, 79 (71.8%) were males, 224 (23.5%) were obese, 56 (50.9%) reported alcohol abuse, 24 (21.8%) had non-alcoholic fatty liver disease, 11 (10%) had viral hepatitis and 98 (89.1%) had pneumonia. The median length of hospitalisation was 12 days; 32 (29.1%) patients required ICU admission and 23 (20.9%) patients required MV, while 43 (39.1%) died. In univariate analysis, patients with cirrhosis (45% vs 73%, hazard ratio (HR) = 2.95; P < 0.001), but not those with non-cirrhotic CLD (74% vs 73%; P > 0.05), experienced worse 30-day survival when compared with age, sex and COVID-19 duration-matched cohorts. In a logistic regression analysis conducted on the overall and matched cohorts, liver cirrhosis, but not CLD, predicted inferior survival independently of age, comorbidities and severity of COVID-19, with a fourfold higher adjusted risk of 30-day mortality.ConclusionCirrhosis is independently associated with higher 30-day mortality of hospitalised patients with COVID-19.© 2022 Royal Australasian College of Physicians.

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