LIVER MANIFESTATIONS IN COVID-19 AND THE INFLUENCE OF PRE-EXISTING LIVER DISEASE IN THE COURSE OF THE INFECTION

Autor: Jesús Rodríguez-Baño, Rocío Galvés Cordero, Isabel Carmona Soria, Patricia Cordero Ruiz, Francisco Vega Rodriguez, María Lorena Cadena Herrera, María J. Ríos-Villegas, Ángel Caunedo Álvarez, María Fernanda Guerra Veloz, Pilar Del Pino Bellido, José Bravo-Ferrer, Carmen Vías Parrado, Francisco Bellido Muñoz
Přispěvatelé: Ministerio de Economía y Competitividad (España), Instituto de Salud Carlos III, Red Española de Investigación en Patología Infecciosa, Ministerio de Ciencia e Innovación (España), European Commission, Universidad de Sevilla. Departamento de Medicina, [Guerra Veloz,MF, Cordero Ruiz,P, Del Pino Bellido,P, Cadena Herrera,ML, Vías Parrado,C, Bellido Muñoz,F, Vega Rodríguez,F, Caunedo Álvarez,Á, Rodríguez-Baño,J, Carmona Soria,I] Gastroenterology and Hepatology Clinical Management Unit, Hospital Universitario Virgen Macarena. Sevilla. [Ríos-Villegas,MJ, Bravo-Ferrer,J] nfectious Diseases, Microbiology and Preventive Medicine Clinical Unit. Hospital Universitario Virgen Macarena. Department of Medicine. Universidad de Sevilla - Instituto de BioMedicina de Sevilla (IBiS). Sevilla, Spain. [Galvés Cordero,R] Internal Medicine Unit. Hospital Universitario Virgen Macarena. Sevilla, Spain., This study was partly supported by Plan Nacional de I+D+i 2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Spanish Ministry of Science and Innovation, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001), co-financed by the European Development Regional Fund 'A way to achieve Europe', Operative Pro gram Intelligence Growth 2014-2020.
Rok vydání: 2020
Předmět:
Male
Analytical
Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings]
Chronic liver disease
Gastroenterology
Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings]
Liver disease
0302 clinical medicine
Prevalence
Risk of mortality
Advanced fibrosis
Hospital admission rate
Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings]
Univariate analysis
COPD
Diseases::Pathological Conditions
Signs and Symptoms::Pathologic Processes::Disease Attributes::Chronic Disease [Medical Subject Headings]
Liver Diseases
Fatty liver
Organisms::Viruses::RNA Viruses::Nidovirales::Coronaviridae::Coronavirus::SARS Virus [Medical Subject Headings]
General Medicine
Middle Aged
Diseases::Digestive System Diseases::Liver Diseases [Medical Subject Headings]
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Sars-cov2
congenital
hereditary
and neonatal diseases and abnormalities
medicine.medical_specialty
Check Tags::Male [Medical Subject Headings]
03 medical and health sciences
Internal medicine
medicine
Humans
Mortality
Aged
Retrospective Studies
SARS-CoV-2
business.industry
COVID-19
Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings]
Retrospective cohort study
medicine.disease
Fibrosis
respiratory tract diseases
Pruebas de admisón rutinarias
Check Tags::Female [Medical Subject Headings]
Hepatopatía terminal
Concomitant
Mortalidad
Information Science::Information Science::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings]
Chronic Disease
business
Zdroj: Digital.CSIC. Repositorio Institucional del CSIC
instname
ISSN: 1130-0108
DOI: 10.17235/reed.2020.7627/2020
Popis: [Introduction] patients with advanced chronic liver disease (CLD) may be at an increased risk of a severe course due to cirrhosis-associated immune dysfunction. The aim of this study was to determine the prevalence of CLD in COVID-19 patients and to analyze the course of the infection, compared with patients with non-liver disease.
[Materials and methods] this was a retrospective single center study of all patients with a positive SARS-CoV-2 polymerase chain reaction (PCR) test from March 23rd to April 30th, 2020. Clinical and biochemical data of patients with and without CLD and COVID-19 were collected from the medical records.
[Result] four hundred and forty-seven patients with a SARS-CoV-2 positive PCR were included, 6.3 % had CLD; 69.7 % of patients with CLD were male, with a median age of 65.5 years and active alcohol consumption and smoking; 75 % had non-advanced liver fibrosis and most had non-alcoholic fatty liver disease (NAFLD). The hospital admission rate (92.9 % vs 47.7 %, p < 0.001), concomitant comorbidities (diabetes 38.5 vs 16.5 %, p = 0.011; obesity 30.8 vs 8.5 %, p = 0.033; cancer 23.1 vs 5 %, p = 0.027; and chronic obstructive pulmonary disease (COPD) 19.2 vs 9 %, p = 0.009) and concomitant antibiotics treatment (19.3 vs 5 %, p = 0.018) were higher in patients with CLD than in those without CLD. In-patient hospital mortality rates were similar in both groups (30.8 vs 19.6 %, p = 0.289). The presence of CLD was not associated with mortality (OR = 1.06; 95 % CI = 0.35-3.18; p = 0.924). However, patients with CLD and COVID-19 who were male, obese or under concomitant antibiotic treatment had the highest risk of mortality according to the univariate analysis.
[Conclusion] patients with CLD had a higher risk of hospital admission, with worse outcomes during the COVID-19 infection associated to other concomitant comorbidities and a suspicion of bacterial co-infection.
Financial support statement: this study was partly supported by Plan Nacional de I+D+i 2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Spanish Ministry of Science and Innovation, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001), co-financed by the European Development Regional Fund “A way to achieve Europe”, Operative Program Intelligence Growth 2014-2020.
Databáze: OpenAIRE
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