ArticleGastro hep advances2025
COVID-19 Pandemic-Related Disruptions in Routine Cirrhosis Care and Associated Clinical Outcomes among San Francisco Bay Area Veterans.
Article in Gastro hep advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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.
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Who cites it
1 citing paper in PubMed.
- Pandemic-Related Disruptions and Hepatocellular Carcinoma Surveillance in Safety-Net Settings.JAMA network open · 2026Article
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Authors and funding
11 authors.
Funding
Abstract
Background and Aims: The COVID-19 pandemic disrupted health-care delivery for chronic conditions managed in specialty care and particularly among socioeconomically disadvantaged and Veteran populations. Clinical outcomes in cirrhosis are highly dependent on routine care, including clinic visits, labs, and imaging. This study examines the pandemic's impact on adherence to cirrhosis-related quality indicators and clinical outcomes among Bay Area Veterans receiving hepatology care. Methods: We conducted a retrospective cohort study of Veterans with cirrhosis seen at San Francisco and Palo Alto Veterans Affairs hepatology clinics (March 2017-March 2023). Adherence to quality indicators-hepatocellular carcinoma (HCC) screening, lab monitoring, and hepatology visits-was compared between prepandemic (2017-2020) and pandemic-postpandemic (2020-2023) periods. Multivariable logistic regression assessed the effect of time and pandemic phase on clinical outcomes, including new hepatic decompensation, new HCC, and liver-related hospitalizations or death. Results: Among 1501 Veterans with cirrhosis (median age 67 years, 97% male), adherence to quality indicators declined during the pandemic, with hepatology visits decreasing from 1.5/year to 1.0/year, and telehealth use increasing sevenfold. Overall mortality rates were higher during the pandemic (21% vs 17%) possibly related to nonliver causes, since on multivariable models, the pandemic phase was associated with lower odds of new decompensation (adjusted odds ratio (aOR) 0.87, 95% confidence interval (CI) 0.5-0.9, Conclusion: The pandemic significantly disrupted cirrhosis care among Bay Area Veterans, potentially resulting in "health debt" that may affect outcomes in coming years. Targeted interventions should re-engage patients, addressing these care gaps and improving clinical outcomes.
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