Background: COVID-19 has rapidly become a major health emergency worldwide . The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear.
Methods: Medical records were collected from 23 Chinese hospitals . Patients with decompensated cirrhosis and age- and sex-matched non-liver disease patients were enrolled with 1:4 ratio using stratified sampling.
Results: There were more comorbidities with higher Chalson Complication Index (p <0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p <0.05) and in decompensated cirrhosis patients . Mortality (p <0.05) and the proportion of severe ill (p <0.001) were significantly high among those patients . Patients in severe ill subgroup had higher mortality (p <0.001), MELD, and CRUB65 score but lower lymphocytes count . Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p <0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance . Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome . Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores.
Conclusions: COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality . MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.