Universität zu Köln

Brozat, Jonathan F., Hanses, Frank, Haelberger, Martina, Stecher, Melanie, Dreher, Michael, Tometten, Lukas, Ruethrich, Maria M., Vehreschild, Janne J., Trautwein, Christian, Borgmann, Stefan, Vehreschild, Maria J. G. T., Jakob, Carolin E. M., Stallmach, Andreas, Wille, Kai, Hellwig, Kerstin, Isberner, Nora, Reuken, Philipp A., Geisler, Fabian, Nattermann, Jacob and Bruns, Tony ORCID: 0000-0002-5576-6914 (2022). COVID-19 mortality in cirrhosis is determined by cirrhosis-associated comorbidities and extrahepatic organ failure: Results from the multinational LEOSS registry. United European Gastroenterol. J., 10 (4). S. 409 - 425. CHICHESTER: JOHN WILEY & SONS LTD. ISSN 2050-6414

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Abstract

Background and Objective International registries have reported high mortality rates in patients with liver disease and COVID-19. However, the extent to which comorbidities contribute to excess COVID-19 mortality in cirrhosis is controversial. Methods We used the multinational Lean European Open Survey on SARS-CoV-2-infected patients (LEOSS) to identify patients with cirrhosis documented between March 2020 and March 2021, when the wild-type and alpha variant were predominant. We compared symptoms, disease progression and mortality after propensity score matching (PSM) for age, sex, obesity, smoking status, and concomitant diseases. Mortality was also compared with that of patients with spontaneous bacterial peritonitis (SBP) without SARS-CoV-2 infection, a common bacterial infection and well-described precipitator of acute-on-chronic liver failure. Results Among 7096 patients with SARS-CoV-2 infection eligible for analysis, 70 (0.99%) had cirrhosis, and all were hospitalized. Risk factors for severe COVID-19, such as diabetes, renal disease, and cardiovascular disease were more frequent in patients with cirrhosis. Case fatality rate in patients with cirrhosis was 31.4% with the highest odds of death in patients older than 65 years (43.6% mortality; odds ratio [OR] 4.02; p = 0.018), Child-Pugh class C (57.1%; OR 4.00; p = 0.026), and failure of two or more organs (81.8%; OR 19.93; p = 0.001). After PSM for demographics and comorbidity, the COVID-19 case fatality of patients with cirrhosis did not significantly differ from that of matched patients without cirrhosis (28.8% vs. 26.1%; p = 0.644) and was similar to the 28-day mortality in a comparison group of patients with cirrhosis and SBP (33.3% vs. 31.5%; p = 1.000). Conclusions In immunologically naive patients with cirrhosis, mortality from wild-type SARS-CoV-2 and the alpha variant is high and is largely determined by cirrhosis-associated comorbidities and extrahepatic organ failure.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brozat, Jonathan F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hanses, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Haelberger, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreher, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Tometten, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruethrich, Maria M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Janne J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Trautwein, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgmann, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakob, Carolin E. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stallmach, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellwig, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Isberner, Nora UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuken, Philipp A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Geisler, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Nattermann, Jacob UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Tony UNSPECIFIED orcid.org/0000-0002-5576-6914 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-694936
DOI:	10.1002/ueg2.12232
Journal or Publication Title:	United European Gastroenterol. J.
Volume:	10
Number:	4
Page Range:	S. 409 - 425
Date:	2022
Publisher:	JOHN WILEY & SONS LTD
Place of Publication:	CHICHESTER
ISSN:	2050-6414
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC LIVER-FAILURE; DECOMPENSATED CIRRHOSIS; OUTCOMES; INFECTIONS Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69493