Publication:
Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

Issued Date

2020-01-01

Resource Type

Article

ISSN

19360541
19360533

DOI

10.1007/s12072-020-10072-8

Other identifier(s)

2-s2.0-85087508326

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Hepatology International. (2020)

Suggested Citation

Shiv Kumar Sarin, Ashok Choudhury, George K. Lau, Ming Hua Zheng, Dong Ji, Sherief Abd-Elsalam, Jaeseok Hwang, Xiaolong Qi, Ian Homer Cua, Jeong Ill Suh, Jun Gi Park, Opass Putcharoen, Apichat Kaewdech, Teerha Piratvisuth, Sombat Treeprasertsuk, Sooyoung Park, Salisa Wejnaruemarn, Diana A. Payawal, Oidov Baatarkhuu, Sang Hoon Ahn, Chang Dong Yeo, Uzziel Romar Alonzo, Tserendorj Chinbayar, Imelda M. Loho, Osamu Yokosuka, Wasim Jafri, Soeksiam Tan, Lau Ing Soo, Tawesak Tanwandee, Rino Gani, Lovkesh Anand, Eslam Saber Esmail, Mai Khalaf, Shahinul Alam, Chun Yu Lin, Wan Long Chuang, A. S. Soin, Hitendra K. Garg, Kemal Kalista, Badamnachin Batsukh, Hery Djagat Purnomo, Vijay Pal Dara, Pravin Rathi, Mamun Al Mahtab, Akash Shukla, Manoj K. Sharma, Masao Omata Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study). Hepatology International. (2020). doi:10.1007/s12072-020-10072-8 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58345

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Title

Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

Author(s)

Shiv Kumar Sarin
 Ashok Choudhury
 George K. Lau
 Ming Hua Zheng
 Dong Ji
 Sherief Abd-Elsalam
 Jaeseok Hwang
 Xiaolong Qi
 Ian Homer Cua
 Jeong Ill Suh
 Jun Gi Park
 Opass Putcharoen
 Apichat Kaewdech
 Teerha Piratvisuth
 Sombat Treeprasertsuk
 Sooyoung Park
 Salisa Wejnaruemarn
 Diana A. Payawal
 Oidov Baatarkhuu
 Sang Hoon Ahn
 Chang Dong Yeo
 Uzziel Romar Alonzo
 Tserendorj Chinbayar
 Imelda M. Loho
 Osamu Yokosuka
 Wasim Jafri
 Soeksiam Tan
 Lau Ing Soo
 Tawesak Tanwandee
 Rino Gani
 Lovkesh Anand
 Eslam Saber Esmail
 Mai Khalaf
 Shahinul Alam
 Chun Yu Lin
 Wan Long Chuang
 A. S. Soin
 Hitendra K. Garg
 Kemal Kalista
 Badamnachin Batsukh
 Hery Djagat Purnomo
 Vijay Pal Dara
 Pravin Rathi
 Mamun Al Mahtab
 Akash Shukla
 Manoj K. Sharma
 Masao Omata

Other Contributor(s)

The First Affiliated Hospital of Wenzhou Medical University
 Institute of Liver and Biliary Sciences
 Dongguk University Gyeongju Hospital
 Severance Hospital
 Kaohsiung Medical University Chung-Ho Memorial Hospital
 Mongolian National University of Medical Sciences
 Seth GS Medical College and KEM Hospital
 Yerevan State Medical University after Mkhitar Heratsi
 Universitas Diponegoro
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Universitas Indonesia
 The Aga Khan University
 Thai Red Cross Agency
 Lanzhou University
 The University of Tokyo
 BYL Nair Charitable Hospital & TN Medical College
 Kyungpook National University Hospital
 Indraprastha Apollo Hospitals
 Keimyung University
 Manipal Hospital
 University of Tanta
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Bangabandhu Sheikh Mujib Medical University
 Prince of Songkla University
 Chiba University
 Humanity and Health Clinical Trial Center
 Fatima University Medical Center
 Liver Transplant Surgery
 Fuyang Second People's Hospital
 Dharmais National Cancer Hospital
 St. Luke's Medical Center-Global City
 Hospital Selayang
 National Center for Communicable Diseases
 Yamanashi Prefectural Central Hospital

Abstract

© 2020, Asian Pacific Association for the Study of the Liver. Background and aims: COVID-19 is a dominant pulmonary disease, with multisystem involvement, depending upon comorbidities. Its profile in patients with pre-existing chronic liver disease (CLD) is largely unknown. We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis. Methods: Data was collected from 13 Asian countries on patients with CLD, known or newly diagnosed, with confirmed COVID-19. Results: Altogether, 228 patients [185 CLD without cirrhosis and 43 with cirrhosis] were enrolled, with comorbidities in nearly 80%. Metabolism associated fatty liver disease (113, 61%) and viral etiology (26, 60%) were common. In CLD without cirrhosis, diabetes [57.7% vs 39.7%, OR = 2.1 (1.1–3.7), p = 0.01] and in cirrhotics, obesity, [64.3% vs. 17.2%, OR = 8.1 (1.9–38.8), p = 0.002] predisposed more to liver injury than those without these. Forty three percent of CLD without cirrhosis presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure [5 (11.6%)] or acute decompensation [4 (9%)]. Liver related complications increased (p < 0.05) with stage of liver disease; a Child-Turcotte Pugh score of 9 or more at presentation predicted high mortality [AUROC 0.94, HR = 19.2 (95 CI 2.3–163.3), p < 0.001, sensitivity 85.7% and specificity 94.4%). In decompensated cirrhotics, the liver injury was progressive in 57% patients, with 43% mortality. Rising bilirubin and AST/ALT ratio predicted mortality among cirrhosis patients. Conclusions: SARS-Cov-2 infection causes significant liver injury in CLD patients, decompensating one fifth of cirrhosis, and worsening the clinical status of the already decompensated. The CLD patients with diabetes and obesity are more vulnerable and should be closely monitored.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/58345

Collections

Scopus 2020