Cirrhosis tied to worse survival among COVID-19 patients

Cirrhosis is associated with poorer survival among chronic liver disease (CLD) patients with the novel coronavirus disease (COVID-19), a recent study has found. Such association is more pronounced in those with more advanced cirrhosis or with alcohol-related liver diseases.

A total of 745 CLD patients with COVID-19 (386 with cirrhosis and 359 without) were enrolled into the study from two international registries. As controls, 652 non-CLD patients with SARS-CoV-2 infection were also enrolled from a UK hospital network.

A total of 150 CLD patients died during the observation period, yielding a mortality rate of 20 percent. Disaggregating further showed that the cirrhosis subgroup had a much higher mortality rate than those without cirrhosis (32 percent vs 8 percent).

Among patients with cirrhosis, the most common death was secondary to COVID-19 lung disease in 71 percent. Those with worse Child-Pugh class also saw higher rates of mortality.

Multivariable analysis confirmed that Child-Pugh class was an important correlate of mortality among CLD patients with COVID-19. Child-Pugh class A patients, for instance, had an almost twofold odds of death (odds ratio [OR], 1.90, 95 percent confidence interval [CI], 1.03–3.52; p=0.04).

Patients with Child-Pugh class B (OR, 4.14, 95 percent CI, 2.4–7.65; p<0.001) and C (OR, 9.32, 95 percent CI, 4.80–18.08; p<0.001) had a much greater likelihood of dying. Alcohol-related liver disease (OR, 1.79, 97 percent CI, 1.03–3.13; p=0.04) and age (OR, 1.02, 95 percent CI, 1.01–1.04; p=0.011) also emerged as significant and independent correlates of mortality.