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Vol. 24. Issue S1.
Abstracts of the 2021 Annual meeting of the ALEH (Asociación Latinoamericana para el Estudio del Hígado)
(September 2021)
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Vol. 24. Issue S1.
Abstracts of the 2021 Annual meeting of the ALEH (Asociación Latinoamericana para el Estudio del Hígado)
(September 2021)
Open Access
P-13 COMPARISON OFF DIFFERENT PROGNOSTIC SCORES FOR PATIENTS WITH CIRRHOSIS HOSPITALIZED WITH SARS – COV 2 INFECTION
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Manuel Mendizabal1,2, Ezequiel Ridruejo2,3, Federico Piñero1,2, Margarita Anders2,4, Martín Padilla5, Luis G. Toro6, Aldo Torre7, Pedro Montes8, Alvaro Urzúa9, Esteban Gonzalez Ballerga10, María Dolores Silveyra11, Douglas Michelato12, Javier Díaz13, Mirta Peralta2,14, Josefina Pages1,2, Sandro Ruiz García15, Isabel Gutierrez Lozano16, Yuridia Macias17, Daniel Cocozzella2,18, Norberto Chavez-Tapia19, Martín Tagle20, Alejandra Dominguez21, Adriana Varón2,22, Emilia Vera Pozo23, Fátima Higuera-de la Tijera24, Carla Bustios25, Damiá Conte26, Nataly Escajadillo27, Andrés J Gómez28, Laura Tenorio13, Mauricio Castillo Barradas29, Maria Isabel Schinoni2,30, Fernando Bessone31, Fernando Contreras32, Leyla Nazal33, Abel Sanchez34, Matías García3, Julia Brutti11, María Cecilia Cabrera8, Godolfino Miranda-Zazueta7, German Rojas10, Maximo Cattaneo9, Graciela Castro-Narro19, Fernando Rubinstein35, Marcelo O. Silva1,2
1 Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
2 Latin American Liver Research Educational and Awareness Network (LALREAN)
3 Liver Section, Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires Argentina
4 Hepatology and Liver Transplant Unit, Hospital Alemán, Buenos Aires, Argentina
5 Gastroenterology Unit, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
6 Hepatology and Liver Transplant Unit, Hospitales de San Vicente Fundación de Medellín y Rionegro, Medellín, Colombia
7 Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición, Ciudad de México, México
8 Gastroenterology Unit, Hospital Nacional Daniel A. Carrión, Callao, Perú
9 Gastroenterology Section, Internal Medicine Department, Hospital Clínico de la Universidad de Chile, Santiago, Chile
10 Department of Gastroenterology, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
11 Department of Internal Medicine, Sanatorio Anchorena, Buenos Aires, Argentina
12 Hospital Especializado en Enfermedades Infecciosas Instituto Couto Maia, Salvador de Bahía, Brazil
13 Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
14 Intensive Care Unit, Hospital de Infecciosas Francisco J Muñiz, Buenos Aires, Argentina
15 Gastroenterology Unit, Hospital de Víctor Lazarte Echegaray, Trujillo, Perú
16 Department of Internal Medicine, Centro Médico ABC, Ciudad de México, México
17 Department of Medicine, IMSS Hospital General Regional No.1 “Dr. Carlos Mc Gregor Sánchez”, Ciudad de México, México
18 Department of Gastroenterology, Hospital Italiano de La Plata, La Plata, Argentina
19 Medica Sur Clinic & Foundation, Ciudad de México, México
20 Gastroenterology Unit, Clínica Anglo-Americana, Lima, Perú
21 Department of Gastroenterology, Hospital Padre Hurtado, Santiago, Chile
22 Liver Unit, Fundación Cardio-Infantil, Bogotá, Colombia
23 Hospital Regional Dr. Teodoro Maldonado Carbo del IESS, Guayaquil, Ecuador
24 Department of Gastroenterology and Hepatology, Hospital General de México “Dr. Eduardo Liceaga”, Ciudad de México, México
25 Gastroenterology Unit, Clínica Delgado, Lima, Perú
26 Unidad de Hígado, Hospital Privado de Córdoba, Córdoba, Argentina
27 Gastroenterology Unit, Hospital Nacional Almanzor Aguinaga Asenjo, Chiclayo, Perú
28 Endoscopy and Transplant Service, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
29 Gastroenterology Unit, Hospital de Especialidades del Centro Médico Nacional La Raza IMSS, Ciudad de México, México
30 Department of Gastroenterology, Hospital Alianza, Bahía, Brazil
31 Department of Gastroenterology, Hospital Provincial del Centenario, Rosario, Argentina
32 Department of Gastroenterology, CEDIMAT, Santo Domingo, Dominican Republic
33 Department of Gastroenterology, Clínica Las Condes, Santiago, Chile
34 Department of Gastroenterology, Hospital Roosevelt, Ciudad de Guatemala, Guatemala
35 Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
Article information
Introduction and Objectives

Viral infections have been described to increase the risk of decompensation in patients with cirrhosis. We aimed to determine the impact of SARS-CoV-2 infection on clinical 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 compared to 16% in those without cirrhosis (P<.0001). Cirrhosis was independently associated to 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.

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