Chronic liver disease not a significant comorbid condition for COVID-19

Jiahao Lin,Ji Whae Choi,Bingting Bao,Paul J Zhang,Wei-Hua Liao,Harrison X Bai,Nigar Anjuman Khurram,Kasey Halsey,Thi My Linh Tran,Lesan Wang,Jing Wu,Michael D Feldman

doi:10.1038/s41598-021-91238-8

Abstract

To explore the role of chronic liver disease (CLD) in COVID-19. A total of 1439 consecutively hospitalized patients with COVID-19 from one large medical center in the United States from March 16, 2020 to April 23, 2020 were retrospectively identified. Clinical characteristics and outcomes were compared between patients with and without CLD. Postmortem examination of liver in 8 critically ill COVID-19 patients was performed. There was no significant difference in the incidence of CLD between critical and non-critical groups (4.1% vs 2.9%, p = 0.259), or COVID-19 related liver injury between patients with and without CLD (65.7% vs 49.7%, p = 0.065). Postmortem examination of liver demonstrated mild liver injury associated central vein outflow obstruction and minimal to moderate portal lymphocytic infiltrate without evidence of CLD. Patients with CLD were not associated with a higher risk of liver injury or critical/fatal outcomes. CLD was not a significant comorbid condition for COVID-19.

Highlights

To explore the role of chronic liver disease (CLD) in COVID-19
With the goal of exploring the complex role of CLD in COVID-19, this study investigated factors associated with critical outcomes for COVID-19 and compared the clinical characteristics and outcomes between patients with and without CLD
With data from one large academic center in the United States, the current study demonstrated that the incidence of CLD in COVID-19 (3.3%) was low and within the range of previous s tudies[4,5,9,13,14]

Summary

Introduction

To explore the role of chronic liver disease (CLD) in COVID-19. Abbreviations CLD Chronic liver disease COVID-19 Coronavirus disease-19 SARS-CoV-2 The severe acute respiratory syndrome CoV-2 coronavirus ICU Intensive care unit SD Standard deviation ALT Alanine aminotransferase AST Aspartate aminotransferase ALP Alkaline phosphatase TP Total protein TB Total bilirubin DB Direct bilirubin NASH Non-alcoholic steatohepatitis NAFLD Nonalcoholic fatty liver disease. As of November 8, 2020, over 49.7 million COVID-19 patients with over 1.2 million deaths globally have been c onfirmed[1] Mortality rates of this pandemic disease were reported to be 2–6%2, which can be associated with comorbidities such as hypertension, diabetes and cardiovascular d isease[3]. The impact of chronic liver disease (CLD) as a comorbidity on the outcome of COVID-19 remains controversial[5,6,7,8]. Worse outcomes were either reported to be associated with CLD or not seen in patients with CLD5–8

Methods

Results

Conclusion