Examining the Impact of COVID-19 on Patients with Liver Disease
Research presented at CHEST 2024 examined outcomes of COVID-19 on patients with alcoholic liver disease, cirrhosis, and non-alcohol steatohepatitis.
Although COVID-19 is known to mostly impact the respiratory system, research has also shown it can damage the liver by using a cell-surface receptor called angiotensin-converting enzyme 2. In patients with pre-existing chronic liver diseases, COVID-19 may trigger a deterioration of liver function and has been associated with significant morbidity and mortality in this population.1
Examining the Impact of COVID-19 on Patients with Liver Disease / Gorodenkoff - stock.adobe.com
Three posters recently examined outcomes of COVID-19 on patients with alcoholic liver disease, cirrhosis, and non-alcohol steatohepatitis (NASH). The study data were presented at the annual meeting of the American College of Chest Physicians, CHEST 2024, which was held October 6 to 9 in Boston, Massachusetts.
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For all 3 studies, investigators from New York Medical College gathered data from the National Inpatient Sample (NIS) database, the largest publicly available all-payer inpatient care database in the United States. From the 2020 NIS database, researchers identified patients hospitalized with COVID-19 and each respective liver condition.
In the first poster, investigators sought to determine the impact of alcoholic liver disease on the severity of COVID-19 infection.2 The study cohort included 140 patients hospitalized with both alcoholic liver disease and COVID-19. Of the patients, the majority ethnic group was Caucasian, followed by Hispanic.
Compared to 339733 patients with COVID-19 who did not have alcoholic liver disease, patients with both conditions had a longer length of hospital stay. Patients with COVID-19 and alcoholic liver disease also had a significantly higher need for invasive ventilation, as well as a significantly higher mortality rate.
“Patients with alcohol liver disease should be counseled to quit alcohol consumption and stay up-to-date with COVID-19 vaccinations,” the authors concluded. “Given the risk of rapid clinical deterioration in patients with alcoholic liver disease and concomitant COVID-19 infection, there should be a low threshold for transfer to the critical care unit.”
In the second poster, investigators sought to determine the impact of cirrhosis on the severity of COVID-19 infection.3 The study cohort included 1128 patients hospitalized with COVID-19 and cirrhosis. Of the patients, the majority ethnic group was Caucasian, followed by Hispanic.
Compared to 338745 patients with COVID-19 who did not have cirrhosis, patients with both conditions had a longer length of hospital stay. Patients with COVID-19 and cirrhosis also had a significantly higher need for invasive ventilation, as well as a significantly higher mortality rate.
“Patients with liver cirrhosis must be advised to be up-to-date with COVID-19 vaccinations” the authors concluded. “Given the risk of rapid clinical deterioration, patients with cirrhosis with concomitant COVID-19 infection must have a low threshold for transfer to the critical care unit for multimodal management and close monitoring.”
In the third poster, investigators sought to determine the impact of NASH on the severity of COVID-19 infection.4 The study cohort included 1122 patients hospitalized with COVID-19 and NASH. Of the patients, the majority ethnic group was Caucasian, followed by Hispanic.
Compared to 338751 patients with COVID-19 who did not have NASH, patients with both conditions had a longer length of hospital stay, though it was not statistically significant. Patients with COVID-19 and NASH also had a significantly higher need for invasive ventilation, as well as a significantly higher mortality rate.
“Patients with NASH should be counseled to stay up-to-date with COVID-19 vaccinations,” the authors concluded. “Given the risk of rapid clinical deterioration in patients with NASH and concomitant COVID-19 infection, there should be a low threshold for transfer to the critical care unit.”
Be sure to stay up to date with all our CHEST 2024 coverage here.
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