Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study
ABSTRACT Aims Patients with cirrhosis are susceptible to decompensation events, including ascites, variceal bleeding (VB), hepatic encephalopathy, or death after COVID‐19 infection. Patients may experience post‐COVID condition (PCC) with multisystem involvement that persists for at least 2 months. M...
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Wiley
2025-03-01
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| Online Access: | https://doi.org/10.1002/jgh3.70142 |
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| author | Prerna Sharma Madhumita Premkumar Rashmi Ranjan Guru Anchal Sandhu Kamal Kajal Arka De Sahaj Rathi Nipun Verma Sunil Taneja Virendra Singh Ajay Kumar Duseja |
| author_facet | Prerna Sharma Madhumita Premkumar Rashmi Ranjan Guru Anchal Sandhu Kamal Kajal Arka De Sahaj Rathi Nipun Verma Sunil Taneja Virendra Singh Ajay Kumar Duseja |
| author_sort | Prerna Sharma |
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| description | ABSTRACT Aims Patients with cirrhosis are susceptible to decompensation events, including ascites, variceal bleeding (VB), hepatic encephalopathy, or death after COVID‐19 infection. Patients may experience post‐COVID condition (PCC) with multisystem involvement that persists for at least 2 months. Methods Hospitalized patients with cirrhosis and COVID‐19 between January 2021 and January 2023 were assessed for decompensation events and mortality and compared to a propensity‐matched cohort of cirrhosis and non‐COVID‐19 sepsis. Both groups were followed for outcomes over 1 year. Results Of 252 patients with Cirrhosis+ COVID‐19 (73% men, aged 48.9 ± 13.7 years, 31%‐diabetes, 44%‐hypertension, 35%‐alcohol‐associated, 34.5%‐metabolic dysfunction‐associated steatotic liver disease; MASLD), 72 (28.6%) died in hospital and 180 (71.4%) recovered, similar to Cirrhosis+ non‐COVID‐sepsis (58/214, 27.1%). Finally,60 (33.3%) met criteria for PCC, 19 (10.5%) had no post COVID‐19 sequelae and 101 (56.1%) patients died (N = 45) or were lost to follow up (N = 56). Late Mortality was higher in Cirrhosis+ COVID‐19 than non‐COVID‐sepsis (56.1% vs. 35.3%, p = 0.026). Patients with PCC were aged 47.6 years, 63.3%‐men, Charlson Comorbidity Index > 4 (51.7%), 45%‐diabetes, 56.7%‐hypertension, with 33.3%, 23.3%, and 43.3% in Child‐Turcotte‐Pugh class A, B and C, respectively. PCC symptoms included persistent dyspnea (34, 43%), cognitive impairment (20, 25.3%), and anxiety (47, 59.4%). On multivariable analysis, predictors of the development of PCC were baseline MELDNa (HR 1.12, 95% CI: 1.05–1.17, p < 0.001) and age (HR 0.9, 95% CI: 0.91–0.99, p = 0.012). Predictors of mortality following COVID‐19 recovery were MELDNa (HR 1.03, 95% CI: 1.01–1.05, p = 0.008), age (HR 1.2, 95% CI: 1.1–1.5, p = 0.002) and hypertension (HR 1.63, 95% CI: 1.07–2.49, p = 0.025). Conclusion COVID‐19 is associated with long‐term mortality in cirrhosis even after recovery from respiratory infection. Long COVID is seen in a third of COVID‐19 survivors in patients with cirrhosis. |
| format | Article |
| id | doaj-art-157623cbdd6f4db3b5397229fae2b607 |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-03-01 |
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| series | JGH Open |
| spelling | doaj-art-157623cbdd6f4db3b5397229fae2b6072025-08-20T02:10:34ZengWileyJGH Open2397-90702025-03-0193n/an/a10.1002/jgh3.70142Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational StudyPrerna Sharma0Madhumita Premkumar1Rashmi Ranjan Guru2Anchal Sandhu3Kamal Kajal4Arka De5Sahaj Rathi6Nipun Verma7Sunil Taneja8Virendra Singh9Ajay Kumar Duseja10Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hospital Administration Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Anesthesia and Critical Care Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaDepartment of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh IndiaABSTRACT Aims Patients with cirrhosis are susceptible to decompensation events, including ascites, variceal bleeding (VB), hepatic encephalopathy, or death after COVID‐19 infection. Patients may experience post‐COVID condition (PCC) with multisystem involvement that persists for at least 2 months. Methods Hospitalized patients with cirrhosis and COVID‐19 between January 2021 and January 2023 were assessed for decompensation events and mortality and compared to a propensity‐matched cohort of cirrhosis and non‐COVID‐19 sepsis. Both groups were followed for outcomes over 1 year. Results Of 252 patients with Cirrhosis+ COVID‐19 (73% men, aged 48.9 ± 13.7 years, 31%‐diabetes, 44%‐hypertension, 35%‐alcohol‐associated, 34.5%‐metabolic dysfunction‐associated steatotic liver disease; MASLD), 72 (28.6%) died in hospital and 180 (71.4%) recovered, similar to Cirrhosis+ non‐COVID‐sepsis (58/214, 27.1%). Finally,60 (33.3%) met criteria for PCC, 19 (10.5%) had no post COVID‐19 sequelae and 101 (56.1%) patients died (N = 45) or were lost to follow up (N = 56). Late Mortality was higher in Cirrhosis+ COVID‐19 than non‐COVID‐sepsis (56.1% vs. 35.3%, p = 0.026). Patients with PCC were aged 47.6 years, 63.3%‐men, Charlson Comorbidity Index > 4 (51.7%), 45%‐diabetes, 56.7%‐hypertension, with 33.3%, 23.3%, and 43.3% in Child‐Turcotte‐Pugh class A, B and C, respectively. PCC symptoms included persistent dyspnea (34, 43%), cognitive impairment (20, 25.3%), and anxiety (47, 59.4%). On multivariable analysis, predictors of the development of PCC were baseline MELDNa (HR 1.12, 95% CI: 1.05–1.17, p < 0.001) and age (HR 0.9, 95% CI: 0.91–0.99, p = 0.012). Predictors of mortality following COVID‐19 recovery were MELDNa (HR 1.03, 95% CI: 1.01–1.05, p = 0.008), age (HR 1.2, 95% CI: 1.1–1.5, p = 0.002) and hypertension (HR 1.63, 95% CI: 1.07–2.49, p = 0.025). Conclusion COVID‐19 is associated with long‐term mortality in cirrhosis even after recovery from respiratory infection. Long COVID is seen in a third of COVID‐19 survivors in patients with cirrhosis.https://doi.org/10.1002/jgh3.70142acute decompensation of cirrhosiscirrhosiscoronavirusCOVID‐19 liver failurelong COVID‐19portal hypertension |
| spellingShingle | Prerna Sharma Madhumita Premkumar Rashmi Ranjan Guru Anchal Sandhu Kamal Kajal Arka De Sahaj Rathi Nipun Verma Sunil Taneja Virendra Singh Ajay Kumar Duseja Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study JGH Open acute decompensation of cirrhosis cirrhosis coronavirus COVID‐19 liver failure long COVID‐19 portal hypertension |
| title | Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study |
| title_full | Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study |
| title_fullStr | Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study |
| title_full_unstemmed | Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study |
| title_short | Post COVID Condition and Long‐Term COVID‐19 Impact on Hepatic Decompensation and Survival in Cirrhosis: A Propensity Matched Observational Study |
| title_sort | post covid condition and long term covid 19 impact on hepatic decompensation and survival in cirrhosis a propensity matched observational study |
| topic | acute decompensation of cirrhosis cirrhosis coronavirus COVID‐19 liver failure long COVID‐19 portal hypertension |
| url | https://doi.org/10.1002/jgh3.70142 |
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