COVID-19 in chronic liver patients; great danger for cirrhosis patiens

Berat Ebik; Nazım Ekin; Ferhat Bacaksız; Jihat Kılıc

doi:10.19161/etd.1166881

TR EN

Kronik karaciğer hastalarında COVID-19; siroz hastaları için büyük tehlike

Öz

Amaç: Sirozu olan ve olmayan kronik karaciğer hastalarında COVID-19’un klinik seyrini ve mortalitesini araştırmak ve sirotik hastalarda COVID’19 sırasında kompansasyon oranlarını belirlemek. Gereç ve Yöntem: Bu çalışmaya, kronik karaciğer hastalığı olan 96 hasta ile (30 tanesi sirotik) herhangi bir komorbid hastalığı bulunmayan 153 hasta alındı. Bu hasta grupları arasında COVID-19’un şiddeti ve mortalitesi açısından fark olup olmadığı incelendi. Bulgular: Sirotik hastaların %46,6’sında (14/30) non-sirotik hastaların %15,1’inde (10/66), kronik karaciğer hastalığı olmayan hastaların %12,4’ünde (19/153)’ünde ağır COVID-19 gelişti (p<0.001). Sirotik hastaların %26,6’sında (8/30) ölüm görülmesine rağmen, kronik karaciğer hastalığı olanlarda ölüm oranı %1,3 (2/153) oldu. Sirotik olmayak kronik karaciğer hastalarında ise mortalite görülmedi. Sirotik hastalarda ölüm oranı kontrol grubundaki hastalara göre anlamlı derecede yüksekti (%26,6’ya karşı %1,3; p<0.001). Sirotik hastaların COVID-19 sırasında Child-Pugh skoru 6,4’ten 8’e (p=0.004) MELD skoru ise 10,4’ten 15,8’e yükseldi (p<0.001). Sonuç: Çalışmamız sonucunda; kronik karaciğer hastalarında, eğer hastanın sirozu yoksa ağır COVID-19 gelişme ve ölüm riskinin karaciğer hastalığı olmayan hastalarla benzer olduğu sonucuna ulaştık. Bu bize korunmuş hepatik rezervin, inflamasyonu tolere edebildiğini gösteriyor. Fakat sirotik hastalarda gelişen COVID-19’un, sirozu olmayan hastalara göre daha ağır seyrettiğini ve mortalitesinin oldukça yüksek olduğunu belirledik. Bu çalışmanın sonuçları bize sirozlu hastalarda COVID-19'un diğer kronik hastalıklarda olduğu gibi mortalite için artmış bir risk faktörü olduğunu gösterdi.

Anahtar Kelimeler

COVID-19 in chronic liver patients; great danger for cirrhosis patiens

Abstract

Aim: The aim of this study; to investigate the clinical course and mortality of COVID-19 in chronic liver patients with and without cirrhosis and to determine decompensation rates during COVID'19 in cirrhotic patients. Materials and Methods: 96 patients with chronic liver disease (30 of them cirrhosis) and 153 patients without any comorbid disease were included in this study. It was examined whether there was a difference among these patient groups in terms of severity and mortality of COVID-19. Results: Severe COVID-19 developed in 46.6% (14/30) cirrhotic patients, in 15.1% (10/66) non-cirrhotic patients, and in 12.4% (19/153) patients with no chronic liver disease (p<0.001). Although mortality was seen in 26.7% (8/30) cirrhotic patients and 1.3% (2/153) of the patients with no chronic liver disease, none of the patients in non-cirrhotic group was died. The rate of mortality in the cirrhotic patient group was statistically significantly higher than in the control group (26.6% vs 1.3%; p<0.001). In the patients with cirrhosis, the Child-Pugh score increased from 6.4 to 8 (p=0.004) and the MELD score from 10.4 to 15.8 during the course of COVID-19 (p<0.001). Conclusion: As a result of our study; we conclude that in patients with chronic liver disease, the risk of developing severe COVID-19 and death is similar to patients without liver disease if the patient does not have cirrhosis. This shows us that preserved hepatic reserve can tolerate inflammation. However, we determined that COVID-19 developing in cirrhotic patients was more severe than in patients without cirrhosis and its mortality was quite high. The results of this study showed us that COVID-19 is an increased risk factor for mortality in patients with cirrhosis, as in other chronic diseases.

Keywords

References

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Berat Ebik ^*
0000-0002-0012-2505
Türkiye

Nazım Ekin
0000-0001-5302-8953
Türkiye

Ferhat Bacaksız
0000-0002-9670-3290
Türkiye

Jihat Kılıc
0000-0003-3722-350X
Türkiye

Publication Date

September 12, 2022

Submission Date

July 14, 2021

Acceptance Date

January 19, 2022

Published in Issue

Year 2022 Volume: 61 Number: 3

DOI

https://doi.org/10.19161/etd.1166881

IZ

https://izlik.org/JA87DP99DR

Cite

RIS / Bibtex

Vancouver

1.Berat Ebik, Nazım Ekin, Ferhat Bacaksız, Jihat Kılıc. COVID-19 in chronic liver patients; great danger for cirrhosis patiens. EJM. 2022 Sep. 1;61(3):319-25. doi:10.19161/etd.1166881