Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection
Introduction and Objectives: Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the effect of SARS-CoV-2 infection on outcome of hospitalized patients with cirrhosis and to compare the performance of different prognostic mode...
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Elsevier
2021
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oai:doaj.org-article:191e2d30a21d4cef87512614101d66222021-11-18T04:46:04ZComparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection1665-268110.1016/j.aohep.2021.100350https://doaj.org/article/191e2d30a21d4cef87512614101d66222021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1665268121000491https://doaj.org/toc/1665-2681Introduction and Objectives: Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the effect of SARS-CoV-2 infection on outcome of hospitalized patients with cirrhosis and to compare the performance of different prognostic models for predicting mortality. Patients: We performed a prospective cohort study including 2211 hospitalized patients with confirmed SARS-CoV-2 infection from April 15, 2020 through October 1, 2020 in 38 Hospitals from 11 Latin American countries. We registered clinical and laboratory parameters of patients with and without cirrhosis. All patients were followed until discharge or death. We evaluated the prognostic performance of different scoring systems to predict mortality in patients with cirrhosis using ROC curves. Results: Overall, 4.6% (CI 3.7–5.6) subjects had cirrhosis (n = 96). Baseline Child-Turcotte-Pugh (CTP) class was assessed: CTP-A (23%), CTP-B (45%) and CTP-C (32%); median MELD-Na score was 19 (IQR 14−25). Mortality was 47% in patients with cirrhosis and 16% in patients without cirrhosis (P < .0001). Cirrhosis was independently associated with death [OR 3.1 (CI 1.9−4.8); P < .0001], adjusted by age, gender, and body mass index >30. The areas under the ROC curves for performance evaluation in predicting 28-days mortality for Chronic Liver Failure Consortium (CLIF-C), North American Consortium for the Study of End-Stage Liver Disease (NACSELD), CTP score and MELD-Na were 0.85, 0.75, 0.69, 0.67; respectively (P < .0001). Conclusions: SARS-CoV-2 infection is associated with elevated mortality in patients with cirrhosis. CLIF-C had better performance in predicting mortality than NACSELD, CTP and MELD-Na in patients with cirrhosis and SARS-CoV-2 infection. Clinicaltrials.gov:NCT04358380.Manuel MendizabalEzequiel RidruejoFederico PiñeroMargarita AndersMartín PadillaLuis G. ToroAldo TorrePedro MontesAlvaro UrzúaEsteban Gonzalez BallergaMaría Dolores SilveyraDouglas MichelatoJavier DíazMirta PeraltaJosefina PagesSandro Ruiz GarcíaIsabel Gutierrez LozanoYuridia MaciasDaniel CocozzellaNorberto Chavez-TapiaMartín TagleAlejandra DominguezAdriana VarónEmilia Vera PozoFátima Higuera-de la TijeraCarla BustiosDamián ConteNataly EscajadilloAndrés J GómezLaura TenorioMauricio Castillo BarradasMaria Isabel SchinoniFernando BessoneFernando ContrerasLeyla NazalAbel SanchezMatías GarcíaJulia BruttiMaría Cecilia CabreraGodolfino Miranda-ZazuetaGerman RojasMaximo CattaneoGraciela Castro-NarroFernando RubinsteinMarcelo O. SilvaElsevierarticleCOVID-19DeathPandemicAcute-on-chronic liver failureCoronavirusCirrhosisSpecialties of internal medicineRC581-951ENAnnals of Hepatology, Vol 25, Iss , Pp 100350- (2021) |
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EN |
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COVID-19 Death Pandemic Acute-on-chronic liver failure Coronavirus Cirrhosis Specialties of internal medicine RC581-951 |
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COVID-19 Death Pandemic Acute-on-chronic liver failure Coronavirus Cirrhosis Specialties of internal medicine RC581-951 Manuel Mendizabal Ezequiel Ridruejo Federico Piñero Margarita Anders Martín Padilla Luis G. Toro Aldo Torre Pedro Montes Alvaro Urzúa Esteban Gonzalez Ballerga María Dolores Silveyra Douglas Michelato Javier Díaz Mirta Peralta Josefina Pages Sandro Ruiz García Isabel Gutierrez Lozano Yuridia Macias Daniel Cocozzella Norberto Chavez-Tapia Martín Tagle Alejandra Dominguez Adriana Varón Emilia Vera Pozo Fátima Higuera-de la Tijera Carla Bustios Damián Conte Nataly Escajadillo Andrés J Gómez Laura Tenorio Mauricio Castillo Barradas Maria Isabel Schinoni Fernando Bessone Fernando Contreras Leyla Nazal Abel Sanchez Matías García Julia Brutti María Cecilia Cabrera Godolfino Miranda-Zazueta German Rojas Maximo Cattaneo Graciela Castro-Narro Fernando Rubinstein Marcelo O. Silva Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| description |
Introduction and Objectives: Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the effect of SARS-CoV-2 infection on outcome of hospitalized patients with cirrhosis and to compare the performance of different prognostic models for predicting mortality. Patients: We performed a prospective cohort study including 2211 hospitalized patients with confirmed SARS-CoV-2 infection from April 15, 2020 through October 1, 2020 in 38 Hospitals from 11 Latin American countries. We registered clinical and laboratory parameters of patients with and without cirrhosis. All patients were followed until discharge or death. We evaluated the prognostic performance of different scoring systems to predict mortality in patients with cirrhosis using ROC curves. Results: Overall, 4.6% (CI 3.7–5.6) subjects had cirrhosis (n = 96). Baseline Child-Turcotte-Pugh (CTP) class was assessed: CTP-A (23%), CTP-B (45%) and CTP-C (32%); median MELD-Na score was 19 (IQR 14−25). Mortality was 47% in patients with cirrhosis and 16% in patients without cirrhosis (P < .0001). Cirrhosis was independently associated with death [OR 3.1 (CI 1.9−4.8); P < .0001], adjusted by age, gender, and body mass index >30. The areas under the ROC curves for performance evaluation in predicting 28-days mortality for Chronic Liver Failure Consortium (CLIF-C), North American Consortium for the Study of End-Stage Liver Disease (NACSELD), CTP score and MELD-Na were 0.85, 0.75, 0.69, 0.67; respectively (P < .0001). Conclusions: SARS-CoV-2 infection is associated with elevated mortality in patients with cirrhosis. CLIF-C had better performance in predicting mortality than NACSELD, CTP and MELD-Na in patients with cirrhosis and SARS-CoV-2 infection. Clinicaltrials.gov:NCT04358380. |
| format |
article |
| author |
Manuel Mendizabal Ezequiel Ridruejo Federico Piñero Margarita Anders Martín Padilla Luis G. Toro Aldo Torre Pedro Montes Alvaro Urzúa Esteban Gonzalez Ballerga María Dolores Silveyra Douglas Michelato Javier Díaz Mirta Peralta Josefina Pages Sandro Ruiz García Isabel Gutierrez Lozano Yuridia Macias Daniel Cocozzella Norberto Chavez-Tapia Martín Tagle Alejandra Dominguez Adriana Varón Emilia Vera Pozo Fátima Higuera-de la Tijera Carla Bustios Damián Conte Nataly Escajadillo Andrés J Gómez Laura Tenorio Mauricio Castillo Barradas Maria Isabel Schinoni Fernando Bessone Fernando Contreras Leyla Nazal Abel Sanchez Matías García Julia Brutti María Cecilia Cabrera Godolfino Miranda-Zazueta German Rojas Maximo Cattaneo Graciela Castro-Narro Fernando Rubinstein Marcelo O. Silva |
| author_facet |
Manuel Mendizabal Ezequiel Ridruejo Federico Piñero Margarita Anders Martín Padilla Luis G. Toro Aldo Torre Pedro Montes Alvaro Urzúa Esteban Gonzalez Ballerga María Dolores Silveyra Douglas Michelato Javier Díaz Mirta Peralta Josefina Pages Sandro Ruiz García Isabel Gutierrez Lozano Yuridia Macias Daniel Cocozzella Norberto Chavez-Tapia Martín Tagle Alejandra Dominguez Adriana Varón Emilia Vera Pozo Fátima Higuera-de la Tijera Carla Bustios Damián Conte Nataly Escajadillo Andrés J Gómez Laura Tenorio Mauricio Castillo Barradas Maria Isabel Schinoni Fernando Bessone Fernando Contreras Leyla Nazal Abel Sanchez Matías García Julia Brutti María Cecilia Cabrera Godolfino Miranda-Zazueta German Rojas Maximo Cattaneo Graciela Castro-Narro Fernando Rubinstein Marcelo O. Silva |
| author_sort |
Manuel Mendizabal |
| title |
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| title_short |
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| title_full |
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| title_fullStr |
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| title_full_unstemmed |
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection |
| title_sort |
comparison of different prognostic scores for patients with cirrhosis hospitalized with sars-cov-2 infection |
| publisher |
Elsevier |
| publishDate |
2021 |
| url |
https://doaj.org/article/191e2d30a21d4cef87512614101d6622 |
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