Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort
Abstract Background Cirrhosis has been pointed out as a clinical entity that leads to worse clinical prognosis in COVID-19 patients. However, this concept is controversial in the literature. We aimed to evaluate clinical outcomes by comparing patients with cirrhosis to those without cirrhosis in a B...
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2025-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-10424-x |
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| author | Luanna Silva Monteiro Menezes Pedro Ferrari Sales da Cunha Magda Carvalho Pires Lucas Rocha Valle Flávia Carvalho Cardoso Costa Maria Angélica Pires Ferreira Milton Henriques Guimarães Júnior Saionara Cristina Francisco Marcelo Carneiro Daniel Vitório Silveira Fernando Graça Aranha Rafael Lima Rodrigues de Carvalho Teresa Cristina de Abreu Ferrari Milena Soriano Marcolino |
| author_facet | Luanna Silva Monteiro Menezes Pedro Ferrari Sales da Cunha Magda Carvalho Pires Lucas Rocha Valle Flávia Carvalho Cardoso Costa Maria Angélica Pires Ferreira Milton Henriques Guimarães Júnior Saionara Cristina Francisco Marcelo Carneiro Daniel Vitório Silveira Fernando Graça Aranha Rafael Lima Rodrigues de Carvalho Teresa Cristina de Abreu Ferrari Milena Soriano Marcolino |
| author_sort | Luanna Silva Monteiro Menezes |
| collection | DOAJ |
| description | Abstract Background Cirrhosis has been pointed out as a clinical entity that leads to worse clinical prognosis in COVID-19 patients. However, this concept is controversial in the literature. We aimed to evaluate clinical outcomes by comparing patients with cirrhosis to those without cirrhosis in a Brazilian cohort. Methods Data from 20,164 COVID-19 inpatients were collected from 41 hospitals in Brazil between March to September 2020 and March 2021 to August 2022. We compared 117 patients with cirrhosis to 632 matched controls. A propensity score model was used to adjust for potential confounding variables, incorporating some predictors: age, sex at birth, number of comorbidities, hospital of admission, whether it was an in-hospital clinical manifestation of COVID-19, and admission year. Closeness was defined as being within 0.16 standard deviations of the logit of the propensity score. Results The median age was 61 (IQR 50–70) years old, and 63.4% were men. There were no significant differences in the self-reported symptoms. Patients with cirrhosis had lower median hemoglobin levels (10.8 vs. 13.1 g/dl), lower platelets (127,000 vs. 200,000 cells/mm3), and leukocyte counts, as well as lower median C-reactive protein (63.0 vs. 76.0 p = 0.044) when compared to controls. They also had higher mortality compared to matched controls (51.3% vs. 21.7%, p < 0.001). They also had higher frequencies of admission in an intensive care unit (51.3% vs. 38.0%, p = 0.007), invasive mechanical ventilation (43.9% vs. 26.6%, p < 0.001), dialysis (17.9% vs. 11.1%, p = 0.038), septic shock (23.9% vs. 14.9%; p = 0.015) and institution of palliative care (19.7% vs. 7.4%; p < 0.001). Conclusions This study has shown that COVID-19 inpatients with cirrhosis had significantly higher incidence of severe outcomes, as well as higher frequency of institution of palliative care when compared to matched controls. Our findings underscore the need for these patients to receive particular attention from healthcare teams and allocated resources. |
| format | Article |
| id | doaj-art-054ab62b5ccd411383209a64479802b4 |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-054ab62b5ccd411383209a64479802b42025-01-19T12:11:46ZengBMCBMC Infectious Diseases1471-23342025-01-0125111010.1186/s12879-024-10424-xClinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohortLuanna Silva Monteiro Menezes0Pedro Ferrari Sales da Cunha1Magda Carvalho Pires2Lucas Rocha Valle3Flávia Carvalho Cardoso Costa4Maria Angélica Pires Ferreira5Milton Henriques Guimarães Júnior6Saionara Cristina Francisco7Marcelo Carneiro8Daniel Vitório Silveira9Fernando Graça Aranha10Rafael Lima Rodrigues de Carvalho11Teresa Cristina de Abreu Ferrari12Milena Soriano Marcolino13Universidade Federal de Minas GeraisHospital Metropolitano Odilon BehrensUniversidade Federal de Minas GeraisUniversidade Federal de Minas GeraisHospitais da Rede Mater DeiHospital de Clínicas de Porto AlegreHospital Márcio CunhaHospital Metropolitano Doutor Célio de CastroHospital Santa CruzHospital Unimed BHHospital SOS CárdioHospital Universitário Professor Edgard SantosUniversidade Federal de Minas GeraisUniversidade Federal de Minas GeraisAbstract Background Cirrhosis has been pointed out as a clinical entity that leads to worse clinical prognosis in COVID-19 patients. However, this concept is controversial in the literature. We aimed to evaluate clinical outcomes by comparing patients with cirrhosis to those without cirrhosis in a Brazilian cohort. Methods Data from 20,164 COVID-19 inpatients were collected from 41 hospitals in Brazil between March to September 2020 and March 2021 to August 2022. We compared 117 patients with cirrhosis to 632 matched controls. A propensity score model was used to adjust for potential confounding variables, incorporating some predictors: age, sex at birth, number of comorbidities, hospital of admission, whether it was an in-hospital clinical manifestation of COVID-19, and admission year. Closeness was defined as being within 0.16 standard deviations of the logit of the propensity score. Results The median age was 61 (IQR 50–70) years old, and 63.4% were men. There were no significant differences in the self-reported symptoms. Patients with cirrhosis had lower median hemoglobin levels (10.8 vs. 13.1 g/dl), lower platelets (127,000 vs. 200,000 cells/mm3), and leukocyte counts, as well as lower median C-reactive protein (63.0 vs. 76.0 p = 0.044) when compared to controls. They also had higher mortality compared to matched controls (51.3% vs. 21.7%, p < 0.001). They also had higher frequencies of admission in an intensive care unit (51.3% vs. 38.0%, p = 0.007), invasive mechanical ventilation (43.9% vs. 26.6%, p < 0.001), dialysis (17.9% vs. 11.1%, p = 0.038), septic shock (23.9% vs. 14.9%; p = 0.015) and institution of palliative care (19.7% vs. 7.4%; p < 0.001). Conclusions This study has shown that COVID-19 inpatients with cirrhosis had significantly higher incidence of severe outcomes, as well as higher frequency of institution of palliative care when compared to matched controls. Our findings underscore the need for these patients to receive particular attention from healthcare teams and allocated resources.https://doi.org/10.1186/s12879-024-10424-xCOVID-19Liver cirrhosisPatient Outcome AssessmentPropensity scoreCohort studies |
| spellingShingle | Luanna Silva Monteiro Menezes Pedro Ferrari Sales da Cunha Magda Carvalho Pires Lucas Rocha Valle Flávia Carvalho Cardoso Costa Maria Angélica Pires Ferreira Milton Henriques Guimarães Júnior Saionara Cristina Francisco Marcelo Carneiro Daniel Vitório Silveira Fernando Graça Aranha Rafael Lima Rodrigues de Carvalho Teresa Cristina de Abreu Ferrari Milena Soriano Marcolino Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort BMC Infectious Diseases COVID-19 Liver cirrhosis Patient Outcome Assessment Propensity score Cohort studies |
| title | Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort |
| title_full | Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort |
| title_fullStr | Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort |
| title_full_unstemmed | Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort |
| title_short | Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort |
| title_sort | clinical outcomes of covid 19 in patients with liver cirrhosis a propensity matched analysis from a multicentric brazilian cohort |
| topic | COVID-19 Liver cirrhosis Patient Outcome Assessment Propensity score Cohort studies |
| url | https://doi.org/10.1186/s12879-024-10424-x |
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