Evaluating Disparities in COVID-19 Clinical Outcomes Among Patients With Cirrhosis in North America and Europe—An International Registry Study

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2024-11-29 DOI:10.1002/jgh3.70064

Umar Hayat, Andrew M. Moon, Manesh K. Gangwani, Fariha Hasan, Thomas Marjot, A. Sidney Barritt IV, Wasique Mirza, Duane Deivert, Muhammad Aziz, Dushyant Singh Dahiya, Hassam Ali, Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia

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Abstract

Background

Patients with decompensated cirrhosis have a higher risk of hospitalization, ICU admission, and death from COVID-19. The impact of demographics on these outcomes remains uncertain.

Methods

The SECURE-Liver and COVID-Hep databases were utilized to evaluate disparities in COVID-19 outcomes. Patients were stratified by North American and European cohorts. Bivariate and multivariable logistic regression was performed.

Results

A total of 718 cirrhosis patients with COVID-19 were evaluated. In the North American cohort, Black patients had more comorbidities (CI: 1.86 vs. 1.83, p < 0.01), higher rates of hospitalization (77% vs. 85%, p < 0.01), ICU admission (27% vs. 40%, p = 0.05), and death (18% vs. 28%, p = 0.07). Hispanic patients had the lowest adverse outcome rates. In the European cohort, White patients had more comorbidities (CI; 1.63 vs. 1.31, p = 0.02), but non-White patients had higher hospitalization rates (82% vs. 67%, p = 0.01), ICU admissions (15% vs. 18%, p = 0.04), and lower mortality rates (28% vs. 34%, p = 0.01).

Conclusion

Black patients in North America had higher hospitalization, ICU admission, and death rates. In the European subgroup, White patients had higher death rates than non-White patients. These disparities became statistically insignificant after adjusting for confounders, suggesting that non-liver-related comorbidities might increase the risk of adverse outcomes.

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评估北美和欧洲肝硬化患者COVID-19临床结局的差异-一项国际注册研究

背景失代偿性肝硬化患者因COVID-19住院、ICU住院和死亡的风险较高。人口结构对这些结果的影响仍不确定。方法利用SECURE-Liver和COVID-Hep数据库评估COVID-19结局的差异。患者按北美和欧洲队列进行分层。进行了双变量和多变量logistic回归。结果共对718例肝硬化合并COVID-19患者进行评估。在北美队列中，黑人患者有更多的合并症（CI: 1.86比1.83,p < 0.01），更高的住院率（77%比85%，p < 0.01）， ICU住院率（27%比40%，p = 0.05）和死亡率（18%比28%，p = 0.07）。西班牙裔患者的不良结果发生率最低。在欧洲队列中，白人患者有更多的合并症(CI；1.63比1.31,p = 0.02)，但非白人患者的住院率较高（82%比67%，p = 0.01）， ICU入院率较高（15%比18%，p = 0.04），死亡率较低（28%比34%，p = 0.01）。结论北美黑人患者的住院率、ICU入院率和死亡率较高。在欧洲亚组中，白人患者的死亡率高于非白人患者。在调整混杂因素后，这些差异在统计学上变得微不足道，这表明非肝脏相关的合并症可能会增加不良结果的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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