Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study

Abstract Background Limited research suggested that liver cirrhosis is an independent risk factor for severe COVID-19, leading to higher hospitalization and mortality rates. This study aimed to identify the prognostic factors and validate scoring systems for predicting mortality in COVID-19 patients...

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Main Authors: Shou-Yen Chen, Chip-Jin Ng, Yan-Bo Huang, Hsiang-Yun Lo
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-024-10223-4
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author Shou-Yen Chen
Chip-Jin Ng
Yan-Bo Huang
Hsiang-Yun Lo
author_facet Shou-Yen Chen
Chip-Jin Ng
Yan-Bo Huang
Hsiang-Yun Lo
author_sort Shou-Yen Chen
collection DOAJ
description Abstract Background Limited research suggested that liver cirrhosis is an independent risk factor for severe COVID-19, leading to higher hospitalization and mortality rates. This study aimed to identify the prognostic factors and validate scoring systems for predicting mortality in COVID-19 patients with liver cirrhosis. Methods This retrospective cohort study extracted electronic health records of patients with COVID-19 who visited the emergency department between April 2021 and September 2022. Adult COVID-19 patients with liver cirrhosis were included, excluding those aged < 18 years and who did not require hospitalization. The primary outcome was in-hospital mortality. The effectiveness of the scoring systems were analyzed for COVID-19 in-house mortality prediction. Results A total of 1,368 adult COVID-19 patients with liver cirrhosis were included in this study. Compared with the survival group, the non-survival group had lower vital signs such as systolic blood pressure and blood oxygen saturation, higher levels of white blood cells, creatinine, bilirubin, and C-reactive protein, and longer prothrombin time. Higher rates of intubation, oxygen use, and dexamethasone use were observed in the non-survivor group. The WHO ordinal scale, MELD, and MELD-Na scores showed good predictive ability for in-hospital mortality. Conclusions The WHO ordinal scale showed the best performance in predicting mortality in patients with cirrhosis and COVID-19. MELD and MELD-Na scores were also found good performance for mortality prediction. Coagulation function, intubation, and dexamethasone administration were the most significant prognostic factors.
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spelling doaj-art-69fdb268a39f49c9a9cf34d0623b23652024-11-24T12:12:46ZengBMCBMC Infectious Diseases1471-23342024-11-012411910.1186/s12879-024-10223-4Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective studyShou-Yen Chen0Chip-Jin Ng1Yan-Bo Huang2Hsiang-Yun Lo3Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of MedicineAbstract Background Limited research suggested that liver cirrhosis is an independent risk factor for severe COVID-19, leading to higher hospitalization and mortality rates. This study aimed to identify the prognostic factors and validate scoring systems for predicting mortality in COVID-19 patients with liver cirrhosis. Methods This retrospective cohort study extracted electronic health records of patients with COVID-19 who visited the emergency department between April 2021 and September 2022. Adult COVID-19 patients with liver cirrhosis were included, excluding those aged < 18 years and who did not require hospitalization. The primary outcome was in-hospital mortality. The effectiveness of the scoring systems were analyzed for COVID-19 in-house mortality prediction. Results A total of 1,368 adult COVID-19 patients with liver cirrhosis were included in this study. Compared with the survival group, the non-survival group had lower vital signs such as systolic blood pressure and blood oxygen saturation, higher levels of white blood cells, creatinine, bilirubin, and C-reactive protein, and longer prothrombin time. Higher rates of intubation, oxygen use, and dexamethasone use were observed in the non-survivor group. The WHO ordinal scale, MELD, and MELD-Na scores showed good predictive ability for in-hospital mortality. Conclusions The WHO ordinal scale showed the best performance in predicting mortality in patients with cirrhosis and COVID-19. MELD and MELD-Na scores were also found good performance for mortality prediction. Coagulation function, intubation, and dexamethasone administration were the most significant prognostic factors.https://doi.org/10.1186/s12879-024-10223-4COVID-19Liver cirrhosisMortalityMELD scoreMELD-Na scoreWHO ordinal scale
spellingShingle Shou-Yen Chen
Chip-Jin Ng
Yan-Bo Huang
Hsiang-Yun Lo
Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
BMC Infectious Diseases
COVID-19
Liver cirrhosis
Mortality
MELD score
MELD-Na score
WHO ordinal scale
title Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
title_full Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
title_fullStr Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
title_full_unstemmed Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
title_short Analyzing prognosis and comparing predictive scoring systems for mortality of COVID-19 patients with liver cirrhosis: a multicenter retrospective study
title_sort analyzing prognosis and comparing predictive scoring systems for mortality of covid 19 patients with liver cirrhosis a multicenter retrospective study
topic COVID-19
Liver cirrhosis
Mortality
MELD score
MELD-Na score
WHO ordinal scale
url https://doi.org/10.1186/s12879-024-10223-4
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