Ruiz Isaac, Huard Geneviève, Fournier Claire, Bissonnette Julien, Castel Hélène, Giard Jeanne-Marie, Villeneuve Jean-Pierre, Fenyves Daphna, Marleau Denis, Willems Bernard, Corsilli Daniel, Correal Florence, Ferreira Victor, Martel Dominic, Mathieu Alexandre, Vincent Catherine, Bilodeau Marc
Liver Unit, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
Intensive Care Unit, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
Can Liver J. 2021 Nov 11;4(4):391-400. doi: 10.3138/canlivj-2021-0022. eCollection 2021 Fall.
The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with chronic liver disease (CLD) and liver transplant (LT) recipients remains a concern. The aim of this study was to report the impact of coronavirus disease 2019 (COVID-19) infection among patients at the tertiary health care centre (CHUM) during the first wave of the SARS-CoV-2 pandemic.
This real-world, retrospective cohort included all patients admitted to our liver unit and/or seen as an outpatient with CLD with or without cirrhosis and/or LT recipients who tested positive to SARS-CoV-2 infection. Cases were considered positive as defined by the detection of SARS-CoV-2 by reverse-transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swabs.
Between April 1 and July 31, 2020, 5,637 were admitted to our liver unit and/or seen as outpatient. Among them, 42 were positive for SARS-CoV-2. Twenty-two patients had CLD without cirrhosis while 16 patients had cirrhosis at the time of the infection (13, 2, and 1 with Child-Pugh A, B, and C scores, respectively). Four were LT recipients. Overall, 15 of 42 patients (35.7%) were hospitalized; among them, 7 of 42 (16.7%) required respiratory support and 4 of 42 (9.5%) were transferred to the intensive care unit. Only 4 of 42 (9.5%) patients died: 2 with CLD without cirrhosis and 2 with CLD with cirrhosis. Overall survival was 90.5%.
This real-world study demonstrates an unexpectedly low prevalence and low mortality in the context of SARS-CoV-2 infection among patients with CLD with or without cirrhosis and LT recipients.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对慢性肝病（CLD）患者和肝移植（LT）受者的影响仍然令人担忧。本研究的目的是报告在SARS-CoV-2大流行第一波期间，三级医疗中心（CHUM）的患者中2019冠状病毒病（COVID-19）感染的影响。
这项真实世界的回顾性队列研究纳入了所有入住我们肝病科和/或门诊就诊的CLD患者（有或无肝硬化）和/或SARS-CoV-2感染检测呈阳性的LT受者。通过对鼻咽拭子进行逆转录聚合酶链反应（RT-PCR）检测到SARS-CoV-2，病例被判定为阳性。
2020年4月1日至7月31日期间，5637人入住我们的肝病科和/或门诊就诊。其中，42人SARS-CoV-2检测呈阳性。22例患者为无肝硬化的CLD，16例患者在感染时患有肝硬化（分别为Child-Pugh A、B和C级评分的13例、2例和1例）。4例为LT受者。总体而言，42例患者中有15例（35.7%）住院治疗；其中，42例中有7例（16.7%）需要呼吸支持，42例中有4例（9.5%）被转入重症监护病房。42例患者中仅4例（9.5%）死亡：2例为无肝硬化的CLD，2例为有肝硬化的CLD。总体生存率为90.5%。
这项真实世界研究表明，在有或无肝硬化的CLD患者以及LT受者中，SARS-CoV-2感染情况下的患病率和死亡率出人意料地低。
