A0462 - Cirrhosis Is Associated With Increased Incidence of Mortality, MACE, and Intubation in COVID-19 Patients: A Multi-Center Study of 3,283 Patients

Lucas Wang, MD, Mujahed Abualfoul, DO, Kristopher Aten, DO, Ariella Azimi, DO, Victor Canela, DO, Lawrence Hoang, MD, Sri Prathivada, MD, Michael Vu, DO, Sherry Zhao, MD, Manavjot Sidhu, MD
Methodist Dallas Medical Center, Dallas, TX

Introduction: Coronavirus Disease 2019 (COVID-19) is typically associated with pulmonary and cardiac complications. Its relationship to the liver and cirrhosis is unclear. Here we describe outcomes such as mortality, major acute cardiovascular events (MACE), and intubation for a cohort of cirrhotic patients hospitalized with COVID-19.

Methods: Using a multi-center facility database, we evaluated outcomes in 3,283 COVID-19 patients at Methodist Health System from March 2020 to December 2020. We determined diagnosis of cirrhosis by manual review of imaging reports and noted the etiology of cirrhosis. We evaluated the relationship between cirrhosis and the incidence of all-cause mortality, MACE (including heart failure exacerbation, cardiac tamponade, pericardial effusion, pericarditis, myocardial infarction, stroke, pulmonary embolism, deep venous thrombosis, and shock), and intubation during admission. Chi-Square test was used to analyze observed variables. Odds ratios were calculated for variables with a statistically significant difference (p < 0.05).

Results: Of the 3,283 patients diagnosed with COVID-19, 54 (1.6%) patients were diagnosed with cirrhosis at the time of admission. Cirrhotic patients were more likely to die compared to non-cirrhotic patients during admission with COVID-19 (27.8% vs. 13.2%, p = 0.002, OR = 2.53, 95% CI = 1.38-4.63). Coincidentally, cirrhotic patients also had higher rates of MACE (42.6% vs. 28.6%, p = 0.03 OR = 1.85, 95% CI = 1.07-3.19) and intubation (29.6% vs. 11.6%, p < 0.001, OR = 3.2, 95% CI = 1.77-5.80) compared to their non-cirrhotic counterparts during admission with COVID-19. Of note, there was no statistically significant difference between these outcomes and cirrhotic patients with Non-Alcoholic Steatohepatitis (NASH) vs. Hepatitis B (HBV) vs. Hepatitis C (HCV) vs. all other etiologies.

Discussion: Our study suggests that cirrhotic patients who are admitted with COVID-19 infection are more likely to experience death, MACE, and intubation compared to their non-cirrhotic counterparts. By having a deeper level of understanding of the clinical course of cirrhotic patients, health care providers can better evaluate, prepare, and treat patients hospitalized with COVID-19 infection in the inpatient setting. Further studies with higher number of cirrhotic patients can further help differentiate variability between each etiology of cirrhosis.


Disclosures:


Lucas Wang, MD, Mujahed Abualfoul, DO, Kristopher Aten, DO, Ariella Azimi, DO, Victor Canela, DO, Lawrence Hoang, MD, Sri Prathivada, MD, Michael Vu, DO, Sherry Zhao, MD, Manavjot Sidhu, MD. A0462 - Cirrhosis Is Associated With Increased Incidence of Mortality, MACE, and Intubation in COVID-19 Patients: A Multi-Center Study of 3,283 Patients, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.