Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis

Abstract Background & aim The impact of Omicron variants on cirrhosis was largely unknown. Herein, we aimed to evaluate the impact of SARS-CoV-2 omicron variants infection on the clinical course and mortality of patients with liver cirrhosis. Methods Between 26 December 2022, and 27 January 2023...

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Main Authors: Fengjiao Wang, Lingxiao Zhu, Yanfei Chen, Lanjuan Li
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11040-z
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author Fengjiao Wang
Lingxiao Zhu
Yanfei Chen
Lanjuan Li
author_facet Fengjiao Wang
Lingxiao Zhu
Yanfei Chen
Lanjuan Li
author_sort Fengjiao Wang
collection DOAJ
description Abstract Background & aim The impact of Omicron variants on cirrhosis was largely unknown. Herein, we aimed to evaluate the impact of SARS-CoV-2 omicron variants infection on the clinical course and mortality of patients with liver cirrhosis. Methods Between 26 December 2022, and 27 January 2023, eighty-two hospitalized patients with cirrhosis and confirmed SARS-CoV-2 infection were enrolled. The clinical and pulmonary CT imaging features were retrospectively collected. A gender and age-matched cohort of 51 non-cirrhotic patients with COVID-19 were also included. Results Our results indicated the symptom heterogeneity in patients with cirrhosis infected with omicron variants. Patients with more severe liver disease tended to have less severe respiratory symptoms and less pulmonary lesions. SARS-CoV-2 omicron did not cause obvious perturbation of liver function or cirrhosis decompensation. In comparison with hospitalized COVID-19 patients without liver cirrhosis, cirrhotic patients showed more severe pulmonary lesions and higher levels of inflammatory cytokine IL-6, but no significant increase in mortality. Multivariate analysis identified lung lesions proportion, MELD ≥ 15 score, and APTT as independent predictors for 28-day-mortality in these patients. Conclusion SARS-CoV-2 omicron variants caused a more severe inflammatory response in cirrhotic patients than in non-cirrhotic patients, but no further deterioration of liver function. Instead, patients with advanced stage of liver cirrhosis showed milder respiratory symptoms and pulmonary lesions. These results underscore the intricate relationship between Omicron infection and cirrhosis, highlighting the necessity for personalized clinical approaches in managing this specific patient group.
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spelling doaj-art-0a71c14c44fb4755890be09356ea56522025-08-20T02:55:35ZengBMCBMC Infectious Diseases1471-23342025-04-0125111010.1186/s12879-025-11040-zClinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosisFengjiao Wang0Lingxiao Zhu1Yanfei Chen2Lanjuan Li3Shandong First Medical UniversityState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of MedicineState Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of MedicineJinan Microecological Biomedicine Shandong LaboratoryAbstract Background & aim The impact of Omicron variants on cirrhosis was largely unknown. Herein, we aimed to evaluate the impact of SARS-CoV-2 omicron variants infection on the clinical course and mortality of patients with liver cirrhosis. Methods Between 26 December 2022, and 27 January 2023, eighty-two hospitalized patients with cirrhosis and confirmed SARS-CoV-2 infection were enrolled. The clinical and pulmonary CT imaging features were retrospectively collected. A gender and age-matched cohort of 51 non-cirrhotic patients with COVID-19 were also included. Results Our results indicated the symptom heterogeneity in patients with cirrhosis infected with omicron variants. Patients with more severe liver disease tended to have less severe respiratory symptoms and less pulmonary lesions. SARS-CoV-2 omicron did not cause obvious perturbation of liver function or cirrhosis decompensation. In comparison with hospitalized COVID-19 patients without liver cirrhosis, cirrhotic patients showed more severe pulmonary lesions and higher levels of inflammatory cytokine IL-6, but no significant increase in mortality. Multivariate analysis identified lung lesions proportion, MELD ≥ 15 score, and APTT as independent predictors for 28-day-mortality in these patients. Conclusion SARS-CoV-2 omicron variants caused a more severe inflammatory response in cirrhotic patients than in non-cirrhotic patients, but no further deterioration of liver function. Instead, patients with advanced stage of liver cirrhosis showed milder respiratory symptoms and pulmonary lesions. These results underscore the intricate relationship between Omicron infection and cirrhosis, highlighting the necessity for personalized clinical approaches in managing this specific patient group.https://doi.org/10.1186/s12879-025-11040-zOmicron variantLiver cirrhosisCOVID-19
spellingShingle Fengjiao Wang
Lingxiao Zhu
Yanfei Chen
Lanjuan Li
Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
BMC Infectious Diseases
Omicron variant
Liver cirrhosis
COVID-19
title Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
title_full Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
title_fullStr Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
title_full_unstemmed Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
title_short Clinical manifestations of SARS-CoV-2 Omicron infection is associated with the stage of liver cirrhosis
title_sort clinical manifestations of sars cov 2 omicron infection is associated with the stage of liver cirrhosis
topic Omicron variant
Liver cirrhosis
COVID-19
url https://doi.org/10.1186/s12879-025-11040-z
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AT lingxiaozhu clinicalmanifestationsofsarscov2omicroninfectionisassociatedwiththestageoflivercirrhosis
AT yanfeichen clinicalmanifestationsofsarscov2omicroninfectionisassociatedwiththestageoflivercirrhosis
AT lanjuanli clinicalmanifestationsofsarscov2omicroninfectionisassociatedwiththestageoflivercirrhosis