Chronic liver disease not a comorbidity of COVID-19

Chronic liver disease (CLD) does not seem to be a strong comorbid condition of the novel coronavirus disease (COVID-19), a recent study has found.

Researchers retrospectively assessed the data of 1,439 COVID-19 patients (mean age 55.2±19.9 years, 50.2 percent men), consecutively hospitalized between March 16 and April 23, 2020. Characteristics and outcomes were compared between those with and without CLD. Postmortem liver examinations in eight critically ill patients were also conducted.

Forty-seven patients were identified to have CLD, yielding an overall prevalence rate of 3.3 percent. CLD frequency did not statistically differ among patients who had critical vs noncritical COVID-19 (4.1 percent vs 2.9 percent; p=0.259).

The frequency of acute liver injury likewise did not differ between CLD and non-CLD patients (65.7 percent vs 49.7 percent; p=0.065), nor did overall survival (log-rank p=0.910) and time to mechanical ventilation or intensive care admission (log-rank p=0.208).

Postmortem studies further revealed that CLD was not a significant comorbidity of COVID-19. Histological assessments showed that variable degrees of lymphocytic portal triaditis and of central vein outflow obstruction and injury, as well as focal fibrin thrombi were the most common findings. CLD, such as cirrhosis, steatosis, and chronic hepatitis, was absent in all eight patients.

Multivariable Cox regression identified age, hypertension, cardiovascular disease, malignancy, and liver injury as significant correlates of clinical outcomes in COVID-19 patients. CLD failed to achieve significance (hazard ratio, 1.175, 95 percent confidence interval, 0.702–1.965; p=0.540).