Virulence (Dec 2021)

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

  • Yong Xiao,
  • Dongwen Wu,
  • Xiao Shi,
  • Shuzhong Liu,
  • Xudong Hu,
  • Chenliang Zhou,
  • Xia Tian,
  • Huimin Liu,
  • Hui Long,
  • Zhihong Li,
  • Ji Wang,
  • Tao Tan,
  • Ying Xu,
  • Bitao Chen,
  • Ting Liu,
  • Heng Zhang,
  • Shihua Zheng,
  • Shunlin Hu,
  • Jun Song,
  • Jie Tang,
  • Jichun Song,
  • Zhengwei Cheng,
  • Weitian Xu,
  • Yongxiang Shen,
  • Wenhu Yu,
  • Yong Xu,
  • Jiao Li,
  • Jing Zhou,
  • Fen Wang,
  • Mingkai Chen

DOI
https://doi.org/10.1080/21505594.2021.1909894
Journal volume & issue
Vol. 12, no. 1
pp. 1199 – 1208

Abstract

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Background: COVID-19 has rapidly become a major health emergency worldwide. The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear. Methods: Medical records were collected from 23 Chinese hospitals. Patients with decompensated cirrhosis and age- and sex-matched non-liver disease patients were enrolled with 1:4 ratio using stratified sampling. Results: There were more comorbidities with higher Chalson Complication Index (p < 0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p < 0.05) and in decompensated cirrhosis patients. Mortality (p < 0.05) and the proportion of severe ill (p < 0.001) were significantly high among those patients. Patients in severe ill subgroup had higher mortality (p < 0.001), MELD, and CRUB65 score but lower lymphocytes count. Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p < 0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance. Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome. Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores. Conclusions: COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality. MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.

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