成人肝硬化患者COVID-19的生存率

Gita Aprilicia, S. Syarif, K. Kalista, A. Sulaiman, I. Hasan, C. Lesmana, Juferdy Kurniawan, C. Jasirwan, S. H. Nababan, R. Gani
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Patients with underlying liver cirrhosis between March 2020-January 2021 with positive confirmation of COVID-19 were enrolled in this study. Liver cirrhosis patients without COVID-19 were enrolled as a comparison. Both liver cirrhosis patients with and without COVID-19 were follow up at the time of hospital admission until 30 days outcome. Kaplan Meier and a log-rank test were conducted to evaluate the comparison of survival rate in liver cirrhosis patients with and without COVID-19. Multivariate Cox Proportional Hazard was conducted to identify the independent risk factors related to survival.Results: There were 22 liver cirrhosis patients with COVID-19 and 116 liver cirrhosis patients included in this study. Presentation of gender and age similar both of them. Predominantly males with average age were 57 years ± 13,60 for cirrhosis with COVID-19 patients and 53 years ± 12,75 for without COVID-19. 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引用次数: 1

摘要

背景:COVID-19是由SARS-CoV-2病毒感染引起的疾病,可导致呼吸衰竭死亡。在已有疾病(包括肝病)的患者中,COVID-19的进展更为严重。最近,一些研究表明,肝硬化合并COVID-19患者的死亡率高于未感染COVID-19的肝硬化患者。然而,对COVID-19在潜在肝硬化患者中的生存研究仍然有限。本研究的目的是评估COVID-19在成年肝硬化患者中的生存。方法:在Cipto Mangunkusumo医院进行观察性研究。本研究纳入了2020年3月至2021年1月期间确诊为COVID-19阳性的潜在肝硬化患者。纳入无COVID-19的肝硬化患者作为比较。对合并和不合并COVID-19的肝硬化患者在入院时进行随访,直到30天结束。Kaplan Meier和log-rank检验比较合并和不合并COVID-19的肝硬化患者的生存率。采用多变量Cox比例风险法确定与生存相关的独立危险因素。结果:本研究共纳入22例新冠肺炎肝硬化患者和116例肝硬化患者。性别和年龄的呈现与两者相似。肝硬化合并COVID-19患者以男性为主,平均年龄为57岁±13.60岁,无COVID-19患者平均年龄为53岁±12.75岁。合并COVID-19的肝硬化患者生存率低于未合并COVID-19的肝硬化患者(35.8% vs 67.2%, p值0.001)。合并COVID-19的肝硬化患者的中位生存期为4天(95% CI: 1-8天),而无COVID-19的肝硬化患者的中位生存期无法达到,因为该组患者的生存率在50%以上。最终模型Cox PH值显示肝硬化合并COVID-19 (HR: 8.99;CI 95%: 4.55 - 17.80, p值0.001)和Child-Pugh C级(HR: 5.61;95% CI: 2.76 ~ 11.40, p值0.001)是与生存不良相关的独立危险因素。结论:合并COVID-19的肝硬化患者生存率低于未合并COVID-19的肝硬化患者。肝硬化合并COVID-19和Child-Pugh C级患者的生存率较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Survival COVID-19 in Adult Patients with Liver Cirrhosis
Background: COVID-19 is a disease caused by infection of SARS-CoV-2 virus which leads to mortality due to respiratory failure. The progression of COVID-19 is more severe in patients with pre-existence morbidities, including liver disease. Recently, a few studie showed that liver cirrhosis patients with COVID-19 had a higher risk of mortality rather than liver cirrhosis patients without COVID-19 infection. Nevertheless, the study of survival COVID-19 in a patient with underlying liver cirrhosis is still limited. The aim of this study is to evaluate the survival of COVID-19 in adult patients with liver cirrhosisMethod: An observational study in Cipto Mangunkusumo Hospital was conducted. Patients with underlying liver cirrhosis between March 2020-January 2021 with positive confirmation of COVID-19 were enrolled in this study. Liver cirrhosis patients without COVID-19 were enrolled as a comparison. Both liver cirrhosis patients with and without COVID-19 were follow up at the time of hospital admission until 30 days outcome. Kaplan Meier and a log-rank test were conducted to evaluate the comparison of survival rate in liver cirrhosis patients with and without COVID-19. Multivariate Cox Proportional Hazard was conducted to identify the independent risk factors related to survival.Results: There were 22 liver cirrhosis patients with COVID-19 and 116 liver cirrhosis patients included in this study. Presentation of gender and age similar both of them. Predominantly males with average age were 57 years ± 13,60 for cirrhosis with COVID-19 patients and 53 years ± 12,75 for without COVID-19. The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19  (35.8% vs. 67.2%, p-value 0.001). Median survival of liver cirrhosis patients with COVID-19 was 4 days (95% CI: 1-8 days), while median survival of liver cirrhosis patients without COVID-19 couldn’t be reached since the survival rate of this group above 50%. Final model Cox PH showed that liver cirrhosis with COVID-19 (HR: 8.99; CI 95%: 4.55 – 17.80, p-value 0.001) and Child-Pugh class C (HR: 5.61; 95% CI: 2.76 – 11.40, p-value 0.001) were the independent risk factors associated with poor survival.Conclusion: The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19. Liver cirrhosis with COVID-19 and Child-Pugh class C were associated with poor survival.
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