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World J Virol. Jan 25, 2023; 12(1): 30-43
Published online Jan 25, 2023. doi: 10.5501/wjv.v12.i1.30
COVID-19 in patients with pre-existing chronic liver disease – predictors of outcomes
Dinesh Walia, Anoop Saraya, Deepak Gunjan
Dinesh Walia, Anoop Saraya, Deepak Gunjan, Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, New Delhi, India
Author contributions: Walia D, Saraya A, and Gunjan D contributed equally to this work; Walia D drafted and edited the manuscript; Saraya A and Gunjan D drafted and critically revised the manuscript; all authors have read and approved the final manuscript
Conflict-of-interest statement: All the authors have none to declare for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deepak Gunjan, MD, Associate Professor, Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, New Delhi, India. drdg_01@rediffmail.com
Received: September 13, 2022
Peer-review started: September 13, 2022
First decision: October 3, 2022
Revised: October 19, 2022
Accepted: December 6, 2022
Article in press: December 6, 2022
Published online: January 25, 2023
Processing time: 126 Days and 11.3 Hours
Abstract

Coronavirus disease 2019 (COVID-19) has affected patients with pre-existing chronic liver disease (CLD) in various ways. The maximum impact was seen on patients with underlying cirrhosis who have shown to have poor clinical outcomes in the form of increased risk of hepatic decompensation, acute-on-chronic liver failure, and even mortality. It is of paramount importance to identify various factors which are associated with unfavorable outcomes for prognostication and making informed management strategy. Many factors have been evaluated in different studies in patients with underlying CLD. Some of these factors include the severity of underlying chronic liver disease, comorbid conditions, age, and severity of COVID-19. Overall, the outcomes are not fav-orable in patients with cirrhosis as evidenced by data from various studies. The main purpose of this review is to identify the predictors of adverse clinical outcomes including mortality in patients with CLD for risk stratification, prognostication, and appropriate clinical management.

Keywords: Severe acute respiratory syndrome coronavirus 2; Cirrhosis; Predictors; Outcomes

Core Tip: Coronavirus disease 2019 (COVID-19) has been shown to negatively affect the outcomes of patients with chronic liver disease. Some of the major factors predicting poor outcomes and mortality as shown by various studies include old age (> 60 years) and presence of comorbidities like diabetes, hypertension, and obesity. Apart from these, the most important outcome measure is the severity of underlying chronic liver disease and in some cases the etiology of chronic liver disease. Another major predictor of outcome is the severity of COVID-19, with respiratory failure being a common cause of mortality. Further data is required to draw a definitive relation between these risk factors and outcomes in these patients.