Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study
Author:
Galiero Raffaele, Pafundi Pia ClaraORCID, Simeon Vittorio, Rinaldi Luca, Perrella Alessandro, Vetrano Erica, Caturano Alfredo, Alfano Maria, Beccia Domenico, Nevola Riccardo, Marfella Raffaele, Sardu Celestino, Coppola Carmine, Scarano Ferdinando, Maggi Paolo, De Lucia Sposito Pellegrino, Vocciante Laura, Rescigno Carolina, Sbreglia Costanza, Fraganza Fiorentino, Parrella Roberto, Romano Annamaria, Calabria Giosuele, Polverino Benedetto, Pagano Antonio, Bologna Carolina, Amitrano Maria, Esposito Vincenzo, Coppola Nicola, Maturo Nicola, Adinolfi Luigi Elio, Chiodini Paolo, Sasso Ferdinando CarloORCID,
Abstract
Background
Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory.
Objectives
Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy).
Methods
COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission.
Results
Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42–4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39–14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21–5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings.
Conclusion
Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.
Publisher
Public Library of Science (PLoS)
Subject
Multidisciplinary
Reference50 articles.
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