Title
Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection
Date Issued
01 November 2021
Access level
open access
Resource Type
journal article
Author(s)
Mendizabal M.
Ridruejo E.
Piñero F.
Anders M.
Padilla M.
Toro L.G.
Torre A.
Montes P.
Urzúa A.
Gonzalez Ballerga E.
Silveyra M.D.
Michelato D.
Díaz J.
Peralta M.
Pages J.
García S.R.
Gutierrez Lozano I.
Macias Y.
Cocozzella D.
Chavez-Tapia N.
Tagle M.
Dominguez A.
Varón A.
Vera Pozo E.
Higuera-de la Tijera F.
Bustios C.
Conte D.
Escajadillo N.
Gómez A.J.
Tenorio L.
Castillo Barradas M.
Schinoni M.I.
Bessone F.
Contreras F.
Nazal L.
Sanchez A.
García M.
Brutti J.
Cabrera M.C.
Miranda-Zazueta G.
Rojas G.
Cattaneo M.
Castro-Narro G.
Rubinstein F.
Silva M.O.
Publisher(s)
Elsevier B.V.
Abstract
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.
Volume
25
Language
English
OCDE Knowledge area
Gastroenterología, Hepatología
Scopus EID
2-s2.0-85106326897
PubMed ID
Source
Annals of Hepatology
ISSN of the container
16652681
Sponsor(s)
We would like to thank ALEH´s executive office for their invaluable help and support on this project, especially to Macarena Muñoz, María Jesús Marcone and Verónica García Huidobro. To Silvina Heisecke from CEMIC-CONICET for the copyediting of this manuscript. Other authors who collaborated with data acquisition: Jonathan Aguirre-Valadez, Silvana Ocampo, Claudio Toledo, Mauricio Orrego, Victoria Mainardi, Marcos Girala, Beatriz Ameigeiras, Pablo Caballini, Aldana Scarpin, Kelly Stephany Casanova Lau and Jorge José Díaz Rodriguez.
Sources of information: Directorio de Producción Científica Scopus