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Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study

2020; Public Library of Science; Volume: 15; Issue: 12 Linguagem: Inglês

10.1371/journal.pone.0243700

1932-6203

Raffaele Galiero, Pia Clara Pafundi, Vittorio Simeon, Luca Rinaldi, Alessandro Perrella, Erica Vetrano, Alfredo Caturano, Maria Rosaria Alfano, Domenico Beccia, Riccardo Nevola, Raffaele Marfella, Celestino Sardu, Carmine Coppola, Ferdinando Scarano, Paolo Maggi, Pellegrino De Lucia Sposito, Laura Vocciante, Carolina Rescigno, Costanza Sbreglia, Fiorentino Fraganza, Roberto Parrella, Annamaria Romano, Giosuele Calabria, Benedetto Polverino, Antonio Pagano, Carolina Bologna, María Amitrano, Vincenzo Esposito, Nicola Coppola, Nicola Maturo, Luigi Elio Adinolfi, Paolo Chiodini, Ferdinando Carlo Sasso,

Long-Term Effects of COVID-19

Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory.Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy).COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission.Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings.Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.