‘Chronic liver disease can add risk of death’
NEW DELHI: Coronavirus disease (Covid-19) patients with chronic liver conditions such as hepatitis B or C and fatty liver have higher chances of death and prolonged stay in intensive care units, found the Asia Pacific Covid-19 Liver Injury Spectrum Study conducted across 13 countries, including India.
Forty-three percent of those who were in the advanced stages of the disease with cirrhosis or scarring due to the ailments died of Covid-19, according to the study recently published in the Hepatology International. This is much higher than the 3 to 5% mortality rate in the general population.
Among those with liver disease, the mortality was nearly twice among those with cirrhosis as compared to those without cirrhosis – 33% against 16.3%. About 20% of those with cirrhosis went into liver failure, according to the study.
“We found that if the bilirubin count is high meaning a patient is jaundiced then they have high mortality. Hence, the treating physicians must account for underlying liver disease other than conditions such as diabetes, hypertension, cancer and heart disease. And, monitor the liver enzymes closely,” said lead author Dr Shiv Sarin, director of the Institute of Liver and Biliary Sciences in Delhi. “Also, the liver enzymes must be checked routinely for Covid-19 patients as many with chronic liver disease are unaware of it. The doctors must watch out for risk factors like obesity, diabetes, gall stones, high triglycerides and alcohol consumption given the high prevalence of metabolism related fatty liver disease,” said Dr Sarin.
The study which observed the health and mortality in 228 patients with chronic liver diseases over 28 days, also found that these patients are at an increased risk of acute liver injury when they get Covid-19. The observation of the patient records showed that those without cirrhosis or scarring developed acute liver injury in the second week or early third week of the infection, but in the first week itself in cirrhotic patients.