• Javaria Aslam, Fahad Qaisar, Mutahra Khaliq, Maryam Khalid, Dur-E- Sabeeh, and Asfand Yar Ali.
• Department of Medicine, Sir Sadiq Abbasi Hospital Bahawalpur, Qauid-e-Azam Medical College, Bahawalpur, Pakistan.
• J Coll Physicians Surg Pak. 2023 Jun 1; 33 (6): 647652647-652.

Objective To evaluate the association between chronic liver disease (CLD) caused by viral hepatitis and COVID-19 hospitalisation, as well as the risk of disease progression and mortality among COVID-19 hospitalised patients in relation to their prior CLD status.Study DesignA cohort study. Place and Duration of the study: Bahawal Victoria Hospital and Sir Sadiq Abbasi hospital, affiliated with Qauid-e-Azam Medical College, Bahawalpur, Pakistan, from July to December 2021.MethodologyIn the main group analysis, the risk of hospitalisation for COVID-19 among CLD patients was determined, with the presence of CLD due to chronic viral hepatitis B and C as the exposure variable and hospitalisation for COVID-19 as the outcome measure. Patients hospitalised for a medical condition other than COVID-19 (non-COVID medical admissions) served as an external control group. In the sub-group analysis, the risk of disease severity and mortality were determined among COVID-19 admitted patients having a prior status of CLD, with disease progression to death serving as the primary outcome measure while the exposure variable remained the same as in the main analysis.ResultsA total of 3,976 participants [mean age 51 ±14.8 years; 54.1% men; 1616 hospitalised with COVID-19, including 27 (1.7%) exposed to CLD; and 2,360 non-COVID medical admissions, including 208 (8.8%) exposed to CLD] were evaluated. There was less likelihood of hospitalisation for COVID-19 among patients with CLD (1.7% vs. 8.8%; RR=0.270; 95% CI=0.189, 0.386; p<0.001). There was less risk of death among CLD patients admitted for COVID-19 when compared with those admitted for non-COVID CLD-related complications (14.8% vs. 35.1%; RR= 0.422; 95% CI=0.168-1.06; p=0.035). Among COVID-19 admissions, CLD was associated with a decreased risk of death compared with other comorbid conditions (14.8% vs. 36.9%; RR=0.401; 95% CI=0.162-0.994; p=0.04).ConclusionCLD caused by viral hepatitis was significantly less likely to be present among COVID-19 hospitalised patients. There was a lower risk of severe COVID-19 and mortality owing to it among CLD patients compared to those with other comorbid conditions.Key WordsCOVID-19, Hospitalisations, Chronic liver disease, Viral hepatitis, COVID-19 severity, Death outcome.

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