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Risk of Severe COVID-19-Related Outcomes among Patients with Cirrhosis: A Population-Based Cohort Study in Canada
Héctor Alexander Velásquez García1,2, Prince A Adu1,3, Ada Okonkwo-Dappa4
1British Columbia Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada.
Insights
Cirrhosis significantly increases hospitalization and intensive care unit (ICU) admission risks for individuals with COVID-19. This finding highlights the vulnerability of patients with cirrhosis to severe coronavirus disease outcomes.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Cirrhosis is a chronic liver disease with significant global health implications.
- COVID-19 has been associated with increased severity and mortality in patients with underlying health conditions.
- The impact of cirrhosis on severe COVID-19 outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between cirrhosis and severe COVID-19 outcomes.
- To determine if cirrhosis increases the risk of hospitalization and ICU admission in COVID-19 patients.
Main Methods:
- Utilized the British Columbia (BC) COVID-19 Cohort, a population-based dataset.
- Included laboratory-confirmed SARS-CoV-2 positive individuals aged ≥18 from January 1, 2021, to December 31, 2021.
- Employed multivariable logistic regression to analyze the association between cirrhosis and severe COVID-19 outcomes.
Main Results:
- The study included 162,509 individuals, with 768 (0.5%) having cirrhosis.
- Cirrhosis was associated with a nearly twofold increased odds of hospitalization (aOR = 1.97).
- Cirrhosis demonstrated over a threefold increased odds of ICU admission (aOR = 3.33), consistent across age groups.
Conclusions:
- Cirrhosis is a significant risk factor for severe COVID-19, leading to higher rates of hospitalization and ICU admission.
- These findings underscore the importance of vigilant monitoring and management of COVID-19 patients with cirrhosis.
- Further research may explore specific mechanisms linking cirrhosis to COVID-19 severity.
Abstract:
We assessed the association between cirrhosis and severe COVID-19-related outcomes among people with laboratory-diagnosed COVID-19 infection in British Columbia, Canada. We used data from the British Columbia (BC) COVID-19 Cohort, a population-based cohort that integrates data on all individuals tested for COVID-19, with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions, and deaths in the Canadian province of BC. We included all individuals aged ≥18 who tested positive for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction from 1 January 2021 to 31 December 2021. Multivariable logistic regression models were used to assess the associations of cirrhosis status with COVID-19-related hospitalization and with ICU admission. Of the 162,509 individuals who tested positive for SARS-CoV-2 and were included in the analysis, 768 (0.5%) had cirrhosis. In the multivariable models, cirrhosis was associated with increased odds of hospitalization (aOR = 1.97, 95% CI: 1.58-2.47) and ICU admission (aOR = 3.33, 95% CI: 2.56-4.35). In the analyses stratified by age, we found that the increased odds of ICU admission among people with cirrhosis were present in all the assessed age-groups. Cirrhosis is associated with increased odds of hospitalization and ICU admission among COVID-19 patients.
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