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Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

Sarin SK 1 , Choudhury A 2 , Lau GK 3 , Zheng MH 4 , Ji D 3 , Abd-Elsalam S 5 Show all authors , Hwang J 6 , Qi X 7 , Cua IH 8 , Suh JI 9 , Park JG 9 , Putcharoen O 10 , Kaewdech A 11 , Piratvisuth T 11 , Treeprasertsuk S 10 , Park S 12 , Wejnaruemarn S 10 , Payawal DA 13 , Baatarkhuu O 14 , Ahn SH 15 , Yeo CD 15 , Alonzo UR 13 , Chinbayar T 16 , Loho IM 17 , Yokosuka O 18 , Jafri W 19 , Tan S 20 , Soo LI 20 , Tanwandee T 21 , Gani R 22 , Anand L 23 , Esmail ES 5 , Khalaf M 5 , Alam S 24 , Lin CY 25 , Chuang WL 25 , Soin AS 26 , Garg HK 27 , Kalista K 28 , Batsukh B 14 , Purnomo HD 29 , Dara VP 30 , Rathi P 31 , Al Mahtab M 24 , Shukla A 32 , Sharma MK 2 , Omata M 33 , APASL COVID Task Force, APASL COVID Liver Injury Spectrum Study (APCOLIS Study-NCT 04345640)

Affiliations 

  • 1 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, 110070, India. [email protected]
  • 2 Department of Hepatology and Liver Transplant, Institute of Liver and Biliary Sciences, New Delhi, 110070, India
  • 3 Humanity and Health Clinical Trial Center, Hong Kong SAR, China
  • 4 Department of Hepatology, NAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 5 Tropical Medicine and Infectious Diseases Department, Tanta University, Tanta, Egypt
  • 6 Keimyung University Dongsan Hospital, Daegu, South Korea
  • 7 CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
  • 8 Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Global City, Philippines
  • 9 Department of Internal Medicine, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
  • 10 Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Thai Red Cross, Bangkok, Thailand
  • 11 Gastroenterology and Hepatology Unit, Department of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 12 Kyungpook National University Hospital, Daegu, South Korea
  • 13 Department of Internal Medicine, Fatima University Medical Center, Valenzuela, Philippines
  • 14 Department of Infectious Diseases, School of Medicine, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia
  • 15 Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
  • 16 National Center for Communicable Diseases, Ulan Bator, Mongolia
  • 17 Department of Gastroenterology and Hepatology "Dharmais", National Cancer Hospital, Jakarta, Indonesia
  • 18 Chiba University, Chiba, Japan
  • 19 Department of Medicine, WGO Training Center, Aga Khan University, Karachi, Pakistan
  • 20 Department of Hepatology, Selayang Hospital, Batu Caves, Malaysia
  • 21 Division of Gastroenterology, Department of Medicine, Faculty of Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 22 Division of Hepatobiliary, Cipto Mangunkusuamo Hospital, University of Indonesia, Jakarta, Indonesia
  • 23 Hepatologist, Manipal Hospital, New Delhi, India
  • 24 Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 25 Division of Infectious Diseases, School of Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  • 26 Liver Transplant Surgery, Medanta, The Medicity, Gurugram, Haryana, India
  • 27 Hepatologist and Gastroenterologist, Indraprastha Apollo Hospital, New Delhi, India
  • 28 Faculty of Medicine, Cipto Mangunkusumo Hospitall, Universitas, Jakarta, Indonesia
  • 29 Kariadi Hospital, Diponegoro University, Semarang, Indonesia
  • 30 Yerevan Medical University, Yerevan, Armenia
  • 31 Department of Gastroenterology, T.N. Medical College, B.Y.L. Nair. Ch. Hospital, Mumbai, India
  • 32 Department of Gastroenterology, Seth GSMC and KEM Hospital, Mumbai, India
  • 33 Department of Gastroenterology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
Hepatol Int, 2020 Sep;14(5):690-700.
PMID: 32623632 DOI: 10.1007/s12072-020-10072-8

Abstract

BACKGROUND AND AIMS: COVID-19 is a dominant pulmonary disease, with multisystem involvement, depending upon comorbidities. Its profile in patients with pre-existing chronic liver disease (CLD) is largely unknown. We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis.

METHODS: Data was collected from 13 Asian countries on patients with CLD, known or newly diagnosed, with confirmed COVID-19.

RESULTS: Altogether, 228 patients [185 CLD without cirrhosis and 43 with cirrhosis] were enrolled, with comorbidities in nearly 80%. Metabolism associated fatty liver disease (113, 61%) and viral etiology (26, 60%) were common. In CLD without cirrhosis, diabetes [57.7% vs 39.7%, OR = 2.1 (1.1-3.7), p = 0.01] and in cirrhotics, obesity, [64.3% vs. 17.2%, OR = 8.1 (1.9-38.8), p = 0.002] predisposed more to liver injury than those without these. Forty three percent of CLD without cirrhosis presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure [5 (11.6%)] or acute decompensation [4 (9%)]. Liver related complications increased (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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