LIVER MANIFESTATIONS IN COVID-19 AND THE INFLUENCE OF PRE-EXISTING LIVER DISEASE IN THE COURSE OF THE INFECTION.

Guerra Veloz, María Fernanda; Cordero Ruiz, Patricia; Rios Villegas, Maria Jose; Del Pino Bellido, Pilar; Bravo-Ferrer, Jose; Galves Cordero, Rocio; Cadena Herrera, Maria Lorena; Vias Parrado, Carmen; Bellido Muñoz, Francisco; Vega Rodriguez, Francisco; Caunedo Álvarez, Ángel; Rodriguez-Baño, Jesus; Carmona Soria, Isabel

Patients with advanced chronic liver disease (CLD) may be at an increased risk of a severe course due to cirrhosis-associated immune dysfunction. The aim of this study was to determine the prevalence of CLD in COVID-19 patients and to analyze the course of the infection, compared with patients with non-liver disease. Material This was a retrospective single center study of all patients with a positive SARS-Cov2 polymerase chain reaction (PCR) test from March 23 to April 30, 2020. Clinical and biochemical data of patients with and without CLD and COVID-19 were collected from the medical records. Result 447 patients with a SARS-Cov2 positive PCR were included, 6.3% had CLD. 69.7% of patients with CLD were male, with a median age of 65.5 years and active alcohol consumption and smoking 75% had non-advanced liver fibrosis and most were Non-alcoholic Fatty Liver Disease (NAFLD). The hospital admission rate (92.9% vs 47.7% p<0.001), concomitant comorbidities (diabetes 38.5 vs 16.5% p=0.011; obesity 30.8 vs 8.5% p=0.033; cancer 23.1 vs 5% p=0.027 and COPD 19.2 vs 9% p=0.009) and concomitant antibiotics treatment (19.3 vs 5%; p= 0.018) were higher in patients with CLD than those without CLD. In-patient hospital mortality rate were similar in both groups (30.8 vs 19.6% p=0.289). The presence of CLD was not associated with mortality (OR= 1.06; 95% IC= 0.35- 3.18; p=0.924). However, patients with CLD and COVID-19 who were male, obese or under concomitant antibiotic treatment had the highest risk of mortality according to the univariate analysis. Conclusion Patients with CLD had a higher risk of hospital admission, with worse outcomes during the COVID-19 infection associated to other concomitant comorbidities and a suspicion of bacterial co-infection.