Clin Mol Hepatol.
2020 Oct;26(4):562-576. 10.3350/cmh.2020.0126.
Clinical outcomes of coronavirus disease 2019 in patients with pre-existing liver diseases: A multicenter study in South Korea
- Lee YR1,2,3
- Kang MK3,4
- Song JE3,5
- Kim HJ3,6
- Kweon YO1,2,3
- Tak WY1,2,3
- Jang SY1,2,3
- Park JG3,4
- Lee C3,5
- Hwang JS3,6
- Jang BK3,6
- Suh JI3,7
- Chung WJ
3,6 - Kim BS3,5
- Park SY1,2,3
- Affiliations
-
- 1Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
- 2Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
- 3Daegu-Gyeongbuk Liver Study Group
- 4Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- 5Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
- 6Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- 7Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea
- KMID: 2507975
- DOI: http://doi.org/10.3350/cmh.2020.0126
Abstract
- Background/Aims
Although coronavirus disease 2019 (COVID-19) has spread rapidly worldwide, the implication of pre-existing liver disease on the outcome of COVID-19 remains unresolved.
Methods
A total of 1,005 patients who were admitted to five tertiary hospitals in South Korea with laboratory-confirmed COVID-19 were included in this study. Clinical outcomes in COVID-19 patients with coexisting liver disease as well as the predictors of disease severity and mortality of COVID-19 were assessed.
Results
Of the 47 patients (4.7%) who had liver-related comorbidities, 14 patients (1.4%) had liver cirrhosis. Liver cirrhosis was more common in COVID-19 patients with severe pneumonia than in those with non-severe pneumonia (4.5% vs. 0.9%, P=0.006). Compared to patients without liver cirrhosis, a higher proportion of patients with liver cirrhosis required oxygen therapy; were admitted to the intensive care unit; had septic shock, acute respiratory distress syndrome, or acute kidney injury; and died (P<0.05). The overall survival rate was significantly lower in patients with liver cirrhosis than in those without liver cirrhosis (log-rank test, P=0.003). Along with old age and diabetes, the presence of liver cirrhosis was found to be an independent predictor of severe disease (odds ratio, 4.52; 95% confidence interval [CI], 1.20–17.02;P=0.026) and death (hazard ratio, 2.86; 95% CI, 1.04–9.30; P=0.042) in COVID-19 patients.
Conclusions
This study suggests liver cirrhosis is a significant risk factor for COVID-19. Stronger personal protection and more intensive treatment for COVID-19 are recommended in these patients.
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