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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)

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dc.contributor.author안상훈-
dc.date.accessioned2020-12-01T17:43:22Z-
dc.date.available2020-12-01T17:43:22Z-
dc.date.issued2020-09-
dc.identifier.issn1936-0533-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/180405-
dc.description.abstractBackground 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.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherSpringer-
dc.relation.isPartOfHEPATOLOGY INTERNATIONAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAcute-On-Chronic Liver Failure* / diagnosis-
dc.subject.MESHAcute-On-Chronic Liver Failure* / virology-
dc.subject.MESHAsia / epidemiology-
dc.subject.MESHBetacoronavirus / isolation & purification-
dc.subject.MESHCoronavirus Infections* / epidemiology-
dc.subject.MESHCoronavirus Infections* / physiopathology-
dc.subject.MESHCoronavirus Infections* / therapy-
dc.subject.MESHDisease Progression-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLiver Cirrhosis* / diagnosis-
dc.subject.MESHLiver Cirrhosis* / epidemiology-
dc.subject.MESHLiver Cirrhosis* / etiology-
dc.subject.MESHLiver Function Tests / methods-
dc.subject.MESHLiver Function Tests / statistics & numerical data-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPandemics*-
dc.subject.MESHPatient Acuity-
dc.subject.MESHPneumonia, Viral* / epidemiology-
dc.subject.MESHPneumonia, Viral* / physiopathology-
dc.subject.MESHPneumonia, Viral* / therapy-
dc.subject.MESHPrognosis-
dc.subject.MESHRisk Assessment-
dc.subject.MESHRisk Factors-
dc.titlePre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorShiv Kumar Sarin-
dc.contributor.googleauthorAshok Choudhury-
dc.contributor.googleauthorGeorge K Lau-
dc.contributor.googleauthorMing-Hua Zheng-
dc.contributor.googleauthorDong Ji-
dc.contributor.googleauthorSherief Abd-Elsalam-
dc.contributor.googleauthorJaeseok Hwang-
dc.contributor.googleauthorXiaolong Qi-
dc.contributor.googleauthorIan Homer Cua-
dc.contributor.googleauthorJeong Ill Suh-
dc.contributor.googleauthorJun Gi Park-
dc.contributor.googleauthorOpass Putcharoen-
dc.contributor.googleauthorApichat Kaewdech-
dc.contributor.googleauthorTeerha Piratvisuth-
dc.contributor.googleauthorSombat Treeprasertsuk-
dc.contributor.googleauthorSooyoung Park-
dc.contributor.googleauthorSalisa Wejnaruemarn-
dc.contributor.googleauthorDiana A Payawal-
dc.contributor.googleauthorOidov Baatarkhuu-
dc.contributor.googleauthorSang Hoon Ahn-
dc.contributor.googleauthorChang Dong Yeo-
dc.contributor.googleauthorUzziel Romar Alonzo-
dc.contributor.googleauthorTserendorj Chinbayar-
dc.contributor.googleauthorImelda M Loho-
dc.contributor.googleauthorOsamu Yokosuka-
dc.contributor.googleauthorWasim Jafri-
dc.contributor.googleauthorSoeksiam Tan-
dc.contributor.googleauthorLau Ing Soo-
dc.contributor.googleauthorTawesak Tanwandee-
dc.contributor.googleauthorRino Gani-
dc.contributor.googleauthorLovkesh Anand-
dc.contributor.googleauthorEslam Saber Esmail-
dc.contributor.googleauthorMai Khalaf-
dc.contributor.googleauthorShahinul Alam-
dc.contributor.googleauthorChun-Yu Lin-
dc.contributor.googleauthorWan-Long Chuang-
dc.contributor.googleauthorA S Soin-
dc.contributor.googleauthorHitendra K Garg-
dc.contributor.googleauthorKemal Kalista-
dc.contributor.googleauthorBadamnachin Batsukh-
dc.contributor.googleauthorHery Djagat Purnomo-
dc.contributor.googleauthorVijay Pal Dara-
dc.contributor.googleauthorPravin Rathi-
dc.contributor.googleauthorMamun Al Mahtab-
dc.contributor.googleauthorAkash Shukla-
dc.contributor.googleauthorManoj K Sharma-
dc.contributor.googleauthorMasao Omata-
dc.contributor.googleauthorAPASL COVID Task Force-
dc.contributor.googleauthorAPASL COVID Liver Injury Spectrum Study-
dc.identifier.doi10.1007/s12072-020-10072-8-
dc.contributor.localIdA02226-
dc.relation.journalcodeJ00986-
dc.identifier.eissn1936-0541-
dc.identifier.pmid32623632-
dc.subject.keywordAcute liver injury-
dc.subject.keywordCOVID-19-
dc.subject.keywordChronic liver disease-
dc.subject.keywordSARS CoV2-
dc.contributor.alternativeNameAhn, Sang Hoon-
dc.contributor.affiliatedAuthor안상훈-
dc.citation.volume14-
dc.citation.number5-
dc.citation.startPage690-
dc.citation.endPage700-
dc.identifier.bibliographicCitationHEPATOLOGY INTERNATIONAL, Vol.14(5) : 690-700, 2020-09-
dc.identifier.rimsid67091-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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