The authors were interested in the impact of COVID-19 on the clinical outcome of patients with cirrhosis. They conducted a retrospective study in which 50 cirrhotic patients with confirmed COVID-19 were enrolled for the month of March (age 67 years, 70% men, 38% virus-related cirrhosis, 52% previously compensated). At diagnosis, 64% of patients presented with fever, 42% with shortness of breath, 22% with encephalopathy. In 96% of cases, the patient needed to be hospitalised or their existing hospitalisation was prolonged. Respiratory-support was required in 71% cases, 52% received antivirals and 80% received heparin. Serum albumin significantly decreased; while bilirubin, creatinine and prothrombin time significantly increased at COVID-19 diagnosis compared with their last available data. The proportion of patients with MELD scores ≥15 increased significantly from 13% to 26%, and acute-on-chronic liver failure and de novo acute liver injury occurred in 14 and 10 patients, respectively. 17 patients died after a median of 10 days from COVID-19 diagnosis, with a 30-day-mortality rate of 34%. The severity of lung and liver injury (according to CLIF-C, CLIF-OF and MELD scores) were independent predictors of mortality. Mortality was found to be significantly higher in hospitalised cirrhotics with COVID-19 than in those hospitalised for bacterial infections. Therefore COVID-19 is associated with liver function deterioration and elevated mortality in cirrhotic patients.
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