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Russian Journal of Gastroenterology, Hepatology, Coloproctology

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Impact of Novel Coronavirus Infection on the Course and Prognosis of Cirrhosis

https://doi.org/10.22416/1382-4376-2023-33-6-65-80

Abstract

Аim: to investigate the impact of COVID-19 on the course and prognosis of cirrhosis.

Materials and methods. This was a cohort study in patients with cirrhosis. We included patients with cirrhosis who underwent a medical examination at our center between September 2019 and March 2020. We determined which of these patients were infected with COVID-19, died of COVID-19, or died of cirrhosis complications within the follow-up period from April 2020 to September 2021. Thereafter, we conducted a second medical examination of these surviving patients with cirrhosis in September to December 2021.

Results. Among the 226 patients included in the study, 57 had COVID-19, among which 19 patients who died of the disease. Acute-on-chronic liver failure (ACLF) developed in 16 (28.1 %) patients with cirrhosis and COVID-19, 13 (81.3 %) of whom died. One of the COVID-19 survivors eventually died of liver decompensation. Twenty patients who did not have COVID-19 died of complications of cirrhosis (ACLF) during the follow-up period. The mortality rate in patients who were infected with COVID-19 was higher than that in patients who were not infected (35.1 % vs. 14.2 %; = 0.001). COVID-19 was an independent risk factor for death in patients with cirrhosis. No liver-specific factors predisposing to COVID-19 infection were identified. A more impaired liver function in the pre-pandemic medical examination was a predisposing factor for death in patients who had COVID-19. Patients who died of COVID-19 had better liver function in the pre-pandemic medical examination than patients without COVID-19 who died of complications of cirrhosis during the follow-up period. The liver-related mortality rate and the incidence of liver decompensation or bleeding from esophageal varices during the follow-up period were not significantly different between patients who recovered from COVID-19 and patients with cirrhosis who did not have COVID-19. Among the analyzed survivors, no significant changes were found in the main indicators of liver function after the follow-up period between patients with and without COVID-19, except for the prothrombin index, which was higher in patients after COVID-19.

Conclusion. COVID-19 worsens the prognosis of patients with cirrhosis but does not substantially affect the course of cirrhosis after the recovery from this infection.

About the Authors

A. G. Ismailova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Albina G. Ismailova — Resident Physician, Department of Internal Disease, Gastroenterology and Hepatology, Faculty of Medicine

19435, Moscow, Pogodinskaya str., 1, build. 1



R. V. Maslennikov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Roman V. Maslennikov — Cand. Sci. (Med.), Teaching Assistant of the Department of Internal Disease, Gastroenterology and Hepatology, Faculty of Medicine

19435, Moscow, Pogodinskaya str., 1, build. 1



M. S. Zharkova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Maria S. Zharkova — Cand. Sci. (Med.), Head of the Department of Hepatology, Clinic of Internal Disease, Gastroenterology and Hepatology named after V.Kh. Vasilenko

19435, Moscow, Pogodinskaya str., 1, build. 1



V. T. Ivashkin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Vladimir T. Ivashkin — Dr. Sci. (Med.), Professor, Full Member of the Russian Academy of Sciences, Head of the Department of Internal Disease, Gastroenterology and Hepatology

19435, Moscow, Pogodinskaya str., 1, build. 1



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Review

For citations:


Ismailova A.G., Maslennikov R.V., Zharkova M.S., Ivashkin V.T. Impact of Novel Coronavirus Infection on the Course and Prognosis of Cirrhosis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2023;33(6):65-80. https://doi.org/10.22416/1382-4376-2023-33-6-65-80

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ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)