Evaluating Disparities in COVID-19 Clinical Outcomes Among Patients With Cirrhosis in North America and Europe-An International Registry Study.

BACKGROUND

Patients with decompensated cirrhosis have a higher risk of hospitalization, ICU admission, and death from COVID-19. The impact of demographics on these outcomes remains uncertain.

METHODS

The SECURE-Liver and COVID-Hep databases were utilized to evaluate disparities in COVID-19 outcomes. Patients were stratified by North American and European cohorts. Bivariate and multivariable logistic regression was performed.

RESULTS

A total of 718 cirrhosis patients with COVID-19 were evaluated. In the North American cohort, Black patients had more comorbidities (CI: 1.86 vs. 1.83,  < 0.01), higher rates of hospitalization (77% vs. 85%, p < 0.01), ICU admission (27% vs. 40%,  = 0.05), and death (18% vs. 28%,  = 0.07). Hispanic patients had the lowest adverse outcome rates. In the European cohort, White patients had more comorbidities (CI; 1.63 vs. 1.31,  = 0.02), but non-White patients had higher hospitalization rates (82% vs. 67%,  = 0.01), ICU admissions (15% vs. 18%,  = 0.04), and lower mortality rates (28% vs. 34%, p = 0.01).

CONCLUSION

Black patients in North America had higher hospitalization, ICU admission, and death rates. In the European subgroup, White patients had higher death rates than non-White patients. These disparities became statistically insignificant after adjusting for confounders, suggesting that non-liver-related comorbidities might increase the risk of adverse outcomes.