Clinical course of COVID-19 in patients with pre-existing decompensated cirrhosis: initial report from China

Qi, Xiaolong; Wang, Jitao; Li, Xinyu; Wang, Zhengyan; Liu, Yanna; Yang, Hua; Li, Xiaodan; Shi, Jindong; Xiang, Huihua; Liu, Tao; Kawada, Norifumi; Maruyama, Hitoshi; Jiang, Zicheng; Wang, Fengmei; Takehara, Tetsuo; Rockey, Don C.; Sarin, Shiv Kumar

BACKGROUND: The clinical characteristics and disease course in COVID-19 patients with pre-existing decompensated cirrhosis has not been described so far. METHODS: In this case series, we report three patients with confirmed COVID-19 and pre-existing decompensated cirrhosis from three hospitals in Hubei, the epicenter of the outbreak in China. RESULT: Patient 1 was a 53-year-old man with hepatitis B virus-related cirrhosis, portal hypertension, and ascites. Though receiving intensive support, he died of irreversible multiple organ dysfunction syndrome 48 days after the onset of the illness. Patient 2 was a 75-year-old woman with a history of schistosomiasis-related cirrhosis, portal hypertension, and ascites. Her family members requested that invasive rescue measures not be undertaken, and she died of acute respiratory distress syndrome 40 days after presenting with COVID-19 infection. Patient 3 was an 87-year-old man with alcohol-related cirrhosis, portal hypertension, and esophageal variceal hemorrhage. He was discharged from the hospital 29 days after illness onset. CONCLUSION: The case series raise the possibility that decompensated cirrhosis may be a risk factor for a poor outcome in patients with COVID-19.