Antibody seroprevalence low in cirrhotic patients with mild COVID-19

In liver cirrhosis patients with an asymptomatic or mildly symptomatic case of the novel coronavirus disease (COVID-19), the seroprevalence of antibodies against SARS-CoV-2 seems to be low, a recent study has found.

The study included 202 cirrhotic patients (median age 70.9 years, 64.9 percent men). While all were positive for COVID-19, only 22.3 percent (n=45) were symptomatic. The most common symptoms were fever and cough (11.9 percent each) and diarrhoea (4.5 percent).

Only three participants tested positive for antibodies against SARS-CoV-2, yielding an overall seroprevalence rate of 1.5 percent. When considering only the asymptomatic patients, the corresponding seroprevalence rose to 1.9 percent.

Notably, all three patients showed no symptoms of COVID-19 but presented with compensated liver cirrhosis. Work arrangements, visits from relatives, and medical visits were the suspected sources of the infection.

During the observation period, 24 participants experienced liver-related events, the most frequent of which was hepatic encephalopathy (37.5 percent). This was followed by ascites (33.3 percent) and gastrointestinal bleeding (16.7 percent). One patient developed hepatocellular carcinoma. Interestingly, such events occurred more commonly among those without vs with postponed hepatology visit.

“To our knowledge, this is the first report on the prevalence of asymptomatic or mildly symptomatic SARS-CoV-2 infection in patients with liver cirrhosis,” the researchers said. “[O]ur study reports a prevalence of positive SARS-CoV-2 antibodies as high as 1.5 percent in a sample of consecutive asymptomatic or mildly symptomatic patients with liver cirrhosis.”