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Impact of SARS-CoV-2 Pandemic on Vascular Liver Diseases

Anna Baiges1, Eira Cerda1, Caroline Amicone2

  • 1Hepatic Hemodynamic Lab, IDIBAPS, CIBERehd, Universitat de Barcelona, Hospital Clínic de Barcelona, Spain, and European Reference Network (ERN) RARE-Liver, Hepatological diseases.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|December 30, 2021
PubMed

Insights

Patients with vascular liver diseases (VLDs), specifically portosinusoidal vascular disease (PSVD) and splanchnic vein thrombosis (SVT), face a higher risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and related mortality. This highlights the need for targeted monitoring and care for these patients during the coronavirus disease 2019 (COVID-19) pandemic.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Epidemiology

Background:

  • Vascular liver diseases (VLDs), including portosinusoidal vascular disease (PSVD), splanchnic vein thrombosis (SVT), and Budd-Chiari syndrome (BCS), are complex conditions.
  • The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with VLDs remains unclear.
  • Assessing COVID-19's effect on VLD patients' hepatic decompensation and survival is crucial.

Purpose of the Study:

  • To evaluate the prevalence and severity of SARS-CoV-2 infection in patients with VLDs.
  • To compare infection rates and outcomes in VLD patients versus the general population (GP).
  • To determine the association between VLDs, COVID-19 severity, hepatic decompensation, and mortality.

Main Methods:

  • An international observational study was conducted from March 2020 to March 2021.
  • Data were collected from 968 patients across Spain and France, including those with PSVD, SVT, and BCS.
  • Infection rates and severity metrics were compared between VLD patients and the GP.

Main Results:

  • The prevalence of SARS-CoV-2 infection was significantly higher in PSVD (19%) and SVT (14%) patients compared to the GP (6.5%).
  • VLD patients experienced increased hospital admissions (14%), ICU admissions (2%), and mortality (4%) from COVID-19 compared to the GP.
  • A history of ascites and post-COVID-19 hepatic decompensation were linked to increased COVID-19 mortality in VLD patients.

Conclusions:

  • Patients with PSVD and SVT are at an elevated risk for SARS-CoV-2 infection.
  • These patient groups also face a higher risk of developing severe COVID-19 disease.
  • VLDs, particularly PSVD and SVT, represent a significant risk factor for adverse COVID-19 outcomes.
Abstract

Keywords:
Budd Chiari SyndromeCOVID-19Portosinusoidal Vascular DiseaseSARS-CoV-2Splanchnic Vein ThrombosisVascular Liver Diseases

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