Outcomes of Liver Cirrhosis Patients Hospitalized for Influenza Compared With COVID-19 Between 2020 and 2021 in the United States.

Abstract

Background: Early studies during the COVID-19 pandemic showed that liver cirrhosis patients were at risk of more severe outcomes of the disease. Past studies have also linked cirrhosis patients with poorer influenza outcomes following admissions.

Aim: To compare how patients with liver cirrhosis fared when admitted for COVID-19 as compared with influenza in the United States.

Methods: The National Inpatient Sample (NIS) from 2016 to 2021 was used. The influenza group of cirrhosis patients was extracted for admissions between 2016 and 2019, while the COVID-19 group involved hospitalizations in 2020 and 2021. Baseline characteristics and differences in outcomes were compared between cirrhosis patients with COVID-19 versus influenza.

Results: We recruited 59,590 cirrhosis patients, among whom 6800 (11.4%) had influenza and 52790 (88.6%) were infected with COVID-19. COVID-19 cases were younger, with more patients having dyslipidemia, diabetes, chronic kidney disease (CKD), obesity, and dementia, but fewer patients were smokers, peripheral vascular disease (PVD), history of stroke, history of myocardial infarction, drug abuse, alcohol abuse, chronic ischemic heart disease (IHD), asthma, COPD, and cancer. Our propensity-score matched sample had 6670 cases with COVID-19 and 6670 with influenza. COVID-19 patients were more likely to suffer from hyponatremia, acute myocardial infarction, cardiogenic shock, severe septic shock, mechanical ventilation use, prolonged mechanical ventilation use, cardiac arrest, acute ischemic stroke, acute kidney injury, and all-cause death, but fewer cases with ascites, and hepatorenal syndrome.

Conclusions: The characteristics of cirrhosis patients admitted with COVID-19 differed from those admitted for influenza, with COVID-19 showing a higher mortality risk and varying differences in other complications.