Evidence map›Paper›PMID 33035628›Full record

ArticleJournal of hepatology2021

Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study.

Thomas Marjot, Andrew M Moon, Jonathan A Cook, Sherief Abd-Elsalam, Costica Aloman, Matthew J Armstrong, Elisa Pose, Erica J Brenner, Tamsin Cargill, Maria-Andreea Catana and 20 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 313 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
313citing papers in PubMed, 9 pooled it
54.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

313 citing papers in PubMed, 9 syntheses or guidelines pooled it, 521 citations in OpenAlex.

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253 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors at 20 institutions in 8 countries.

Thomas MarjotOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK. Electronic address: Thomas.marjot@ndm.ox.ac.uk.
Andrew M MoonDivision of Gastroenterology and Hepatology, University of North Carolina, North Carolina, USA.
Jonathan A CookCentre for Statistics in Medicine, University of Oxford, Oxford, UK.
Sherief Abd-ElsalamTropical Medicine and Infectious diseases Department, Tanta University, Tanta, Egypt.
Costica AlomanDepartment of Medicine, Section of Hepatology, Rush University Medical Center, Chicago, Illinois, USA.
Matthew J ArmstrongLiver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Elisa PoseLiver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
Erica J BrennerDivision of Pediatric Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Tamsin CargillOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
Maria-Andreea CatanaDivision of Gastroenterology/Hepatology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Renumathy DhanasekaranDivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
Ahad EshraghianShiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran.
Ignacio García-JuárezDepartment of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Upkar S GillBarts Liver Centre, Barts Health NHS Trust & Barts & The London School of Medicine & Dentistry, QMUL, London, UK.
Patricia D JonesDivision of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
James KennedyOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
Aileen MarshallSheila Sherlock Liver Unit, Royal Free Hospital, London, UK.
Charmaine MatthewsDepartment of Gastroenterology and Hepatology, Royal Liverpool Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
George MellsCambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
Carolyn MercerOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
Ponni V PerumalswamiDivision of Liver Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Emma AvitabileLiver Unit, Hospital Clínic, Barcelona, Spain Institut d'Investigacions Biomèdiques, August Pi i Sunyer, Barcelona, Spain.
Xialong QiCHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China.
Feng SuDivision of Gastroenterology, University of Washington, Seattle, WA, USA.
Nneka N UfereLiver Center, Gastrointestinal Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Yu Jun WongDepartment of Gastroenterology & Hepatology, Changi General Hospital Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ming-Hua ZhengMAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease, Zhejiang Province, Wenzhou, Zhejiang, China.
Eleanor BarnesOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK.
Alfred S BarrittDivision of Gastroenterology and Hepatology, University of North Carolina, North Carolina, USA.
Gwilym J WebbOxford Liver Unit, Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK; Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
University of Oxford · GBUniversity of Cambridge · GBBarts Health NHS Trust · GBBeth Israel Deaconess Medical Center · USCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESFirst Hospital of Lanzhou University · CNHarvard University · USIcahn School of Medicine at Mount Sinai · USInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán · MXNational University of Singapore · SGQueen Elizabeth Hospital Birmingham · GBRush University Medical Center · USSina Hospital · IRStanford University · USTanta University Hospital · EGThe Royal Free Hospital · GBUniversity of Liverpool · GBUniversity of Miami · USUniversity of North Carolina at Chapel Hill · US

Funding

Re-Entry Supplement: Investigation of Oral Microbial Enzymes for the Detection and Treatment of Periodontal DiseaseUL1TR002489 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, SHAHEEN, NICHOLAS J · 2018 to 2022
$48.6M
DIGESTIVE DISEASES EPIDEMIOLOGY TRAINING PROGRAMT32DK007634 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ROBERT S. SANDLER · 1990 to 2026
$7.4M
NCATS NIH HHS UL1 TR002489NIDDK NIH HHS T32 DK007634
6 · The paper itself

Abstract

BACKGROUND &

aimsChronic liver disease (CLD) and cirrhosis are associated with immune dysregulation, leading to concerns that affected patients may be at risk of adverse outcomes following SARS-CoV-2 infection. We aimed to determine the impact of COVID-19 on patients with pre-existing liver disease, which currently remains ill-defined.

methodsBetween 25th March and 8th July 2020, data on 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) were collected by 2 international registries and compared to data on non-CLD patients with SARS-CoV-2 from a UK hospital network.

resultsMortality was 32% in patients with cirrhosis compared to 8% in those without (p <0.001). Mortality in patients with cirrhosis increased according to Child-Pugh class (A [19%], B [35%], C [51%]) and the main cause of death was from respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (odds ratio [OR] 1.02; 1.01-1.04), Child-Pugh A (OR 1.90; 1.03-3.52), B (OR 4.14; 2.4-7.65), or C (OR 9.32; 4.80-18.08) cirrhosis and alcohol-related liver disease (OR 1.79; 1.03-3.13). Compared to patients without CLD (n = 620), propensity-score-matched analysis revealed significant increases in mortality in those with Child-Pugh B (+20.0% [8.8%-31.3%]) and C (+38.1% [27.1%-49.2%]) cirrhosis. Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of whom 21% had no respiratory symptoms. Half of those with hepatic decompensation had acute-on-chronic liver failure.

conclusionsIn the largest such cohort to date, we demonstrate that baseline liver disease stage and alcohol-related liver disease are independent risk factors for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic. LAY SUMMARY: This international registry study demonstrates that patients with cirrhosis are at increased risk of death from COVID-19. Mortality from COVID-19 was particularly high among patients with more advanced cirrhosis and those with alcohol-related liver disease.

Indexed as

Acute-On-Chronic Liver FailureCOVID-19Liver CirrhosisDisease ProgressionFemaleGlobal HealthHospitalizationHumansLiver Function TestsMaleMiddle AgedMortalityRegistriesRisk AssessmentRisk FactorsSARS-CoV-2Acute-on-chronic liver failureChronic liver diseaseCirrhosisCOVID-19SARS-CoV-2

Identifiers

PMID33035628
PMCPMC7536538
OpenAlexW3089697169

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.