Impact of COVID infection on outcome of patients with acute on chronic liver failure

Kovammal, Shemin Shah Jayshri Osuoha Glenda Zulfikar Seema Asfandyar Syed

P083 Table 1 Pre Covid/Group A (n=35) Covid/Group B (n=31) Mean Age 56.63 ± 12.5 SD 59.16 ± 10.75 SD Gender Male 21 (60%) 20 (64.5%) Female 14 (40%) 11 (35.5%) Median MELD Score 21(Range 6–40) 21(Range 9–32) Median Child Pugh Score 11 (Rang 6–14) 12(Range 10–15) Median ACLF Score 8 (Range 6–11) 8 (Range 6 -15) No ACLF 27 (77%) 21 (67%) ACLF grade 1 5 4 ACLF grade 2 2 5 ACLF grade3 1 1 Average Performance score 1 (Range 0–2) 1 (Range 0–3) Patients referred to ITU Patients referred to ITU 4 (11%) 8 (25%) Patients accepted for ITU 3 6 Median CLIF – C Score 54 (Range 45–58) 56 (Range 51- 61) Average Performance Score 1 (Range 0–1) 1 (Range 0–1) Average ITU days 9 (Range 6 – 13) 7 (Range 1–16) Mortality 1 (25%) 4 (66.6%) Patients who received ward-based care Number of patients admitted for ward-based care 32 (91.4%) 25 (80.6%) Median MELD score 18 (Range 6–27) 21 (Range (9–32) Average hospital days 14 days (Range 3 -80) 16 days (Range 3–31) Mortality 5 (16%) 9 (36%) Median MELD score for patients with mortality 21 (Range 21- 28) 26 (Range 13- 40) Patients who recovered & got Discharged Number of patients 29 (82.8%) 18 (58%) Median MELD score 15 (Range 6–22) 19 (Range 9 – 28) Median ACLF score 7(Range 6- 11) 8(Range 6- 11) Average Performance Score 1 (Range 0- 2) 1 (Range 0–2) Patients who Died Number of patients 6 (17%) 13 (41%) Median MELD Score 21(Range 18 – 28) 28 (Range 13- 40) Median ACLF score 8 (Range 6–11) 9 (Range 6 -15) Average Performance Score 1(Range 0–2) 1(Range 0–2) ConclusionCOVID pneumonitis influenced the outcome of patients admitted with hepatic decompensation resulting in increased mortality. Alcohol was the commonest cause of underlying liver disease in both Pre-COVID and COVID period. Age, nature of hepatic decompensation (Gastro-intestinal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis) CLIF-C score for patients referred to ITU and average hospital stay was not much different in both the groups. The median MELD and ACLF grade were higher in patients who died compared to those who recovered.