A Danish population-based case series of patients with liver cirrhosis and coronavirus disease 2019.

OBJECTIVES

Coronavirus disease 2019 (COVID-19) is an ongoing major health emergency, but its occurrence and clinical impact on patients withliver cirrhosis is unknown. Therefore, we conducted a population-based study of 2.6 million Danish citizens investigating the occurrence and impact of COVID-19 in patients with liver cirrhosis.

MATERIALS AND METHODS

A prospective population-based cohort study was conducted in the Capital Region of Denmark and Region Zealand in the study period between 1 March 2020 up until 31 May 2020, with the only eligibility criteria being a reverse-transcriptase polymerase chain reaction for presence of viral genomic material confirming COVID-19. The patients were subsequently stratified according to presence of pre-existing liver cirrhosis.

RESULTS

Among 575,935 individuals tested, 1713 patients had a diagnosis of cirrhosis. COVID-19 occurredsignificantly lessamongpatients with cirrhosis ( = 15; 0.9%,  .01) compared with the population without cirrhosis ( = 10,593; 1.8%). However, a large proportion ( = 6;40.0%) required a COVID-19 related hospitalization which was correlated with higher values of alanine aminotransferase ( .01) and lactate dehydrogenase ( = .04). In addition, one-in-three ( = 2; 13.3%) required intensive therapy. Four patients died (26.7%) and mortality was associated with higher MELD scores, co-existing type 2 diabetes, and bacterial superinfections.

CONCLUSION

In conclusion, patientswith cirrhosis may have a lower risk of COVID-19; but a higher risk of complications hereto and mortality.