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A Danish population-based case series of patients with liver cirrhosis and coronavirus disease 2019

Mohamed Attauabi1,2, Johan Burisch1,2, Flemming Bendtsen1,2

  • 1Gastrounit, Medical Section, Copenhagen University Hospital, Hvidovre, Denmark.

Scandinavian Journal of Gastroenterology
|February 16, 2021
PubMed

Insights

Patients with liver cirrhosis had a lower incidence of COVID-19 but faced a higher risk of severe complications and mortality. This population-based study highlights the critical need for vigilant monitoring and management of COVID-19 in cirrhosis patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Liver cirrhosis is a significant global health concern.
  • The impact of Coronavirus disease 2019 (COVID-19) on patients with liver cirrhosis remains largely unknown.
  • Understanding COVID-19's effects in this vulnerable population is crucial for public health strategies.

Purpose of the Study:

  • To investigate the occurrence of COVID-19 in individuals with liver cirrhosis.
  • To assess the clinical outcomes and mortality associated with COVID-19 in patients with liver cirrhosis.
  • To identify risk factors for severe COVID-19 outcomes in this cohort.

Main Methods:

  • A prospective, population-based cohort study was conducted in Denmark.
  • Data included 2.6 million citizens tested for COVID-19 between March and May 2020.
  • Patients were stratified based on the presence of pre-existing liver cirrhosis.

Main Results:

  • COVID-19 occurred less frequently in patients with cirrhosis (0.9%) compared to the general population (1.8%).
  • However, patients with cirrhosis had higher rates of hospitalization (40.0%), intensive therapy (13.3%), and mortality (26.7%).
  • Higher MELD scores, type 2 diabetes, and bacterial superinfections were associated with increased mortality.

Conclusions:

  • Patients with liver cirrhosis may have a reduced risk of contracting COVID-19.
  • Cirrhosis patients face a significantly elevated risk of severe COVID-19 complications and death.
  • This underscores the importance of tailored management and preventative measures for COVID-19 in liver cirrhosis patients.
Abstract

Keywords:
COVID-19acute-on-chronic liver failurecoronavirus disease 2019disease courseepidemiologyinfectious diseasesliver cirrhosismortalitypopulation-basedsuperinfections

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