Alcoholics treated differently
Paris – A survey of people hospitalised for Covid-19 found those with chronic liver disease and a history of alcohol abuse were 80% more likely to die from the virus and less likely to receive life-saving intubation.
In research presented at the International Liver Congress, researchers based in France analysed the national database of 259 000 Covid patients admitted to hospitals in 2020. Some 16 300 of those had been previously diagnosed with chronic liver disease.
The average rate of death among all patients hospitalised with the virus was 15%. Among those with chronic liver disease, the rate jumped to nearly a quarter.
While previous studies had looked at liver failure as a factor in the severity of Covid, this study found mortality could be linked to which patients were placed on ventilation.
According to the study, patients who suffered alcoholism, advanced cirrhosis or liver cancer and showed higher Covid-19 morbidity and were less likely to have been intubated.
Patients with milder liver problems, from chronic liver disease unrelated to alcohol abuse, organ transplants and viral hepatitis for example, were not at heightened risk for Covid-19 mortality but received ventilation at a greater rate.
“Our results suggest that a limitation of the therapeutic effort may have contributed to the excess mortality of patients with a liver-related complication and of patients with alcohol use disorders,” the study said.
Thomas Berg, incoming president of the European Association for the Study of the Liver, said the findings reflected a trend in care for liver patients that pre-dates the pandemic.
“There is already some public data showing that having a liver-related complication and an alcohol-abuse disorder reduces the likelihood of being mechanically ventilated by 2025%,” he said.
A 2013 US survey of 300 people with mild and advanced liver diseases found the majority of respondents perceived a stigma against their diagnosis.
“Most patients are willing to talk about if they have a cardiac disease or cancer,” Berg said, “but when it comes to liver disease there is always the perception it is self-inflicted, related to drugs or alcohol.” –