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©The Author(s) 2023.
World J Virol. Sep 25, 2023; 12(4): 221-232
Published online Sep 25, 2023. doi: 10.5501/wjv.v12.i4.221
Published online Sep 25, 2023. doi: 10.5501/wjv.v12.i4.221
Table 1 Baseline biodemographic characteristics of hospitalized coronavirus disease 2019 patients with and without alcohol-associated cirrhosis, n (%)
| Factor | Alcoholic cirrhosis | No alcoholic cirrhosis (before matching) | P value | No alcoholic cirrhosis (after matching) | P value |
| Total hospitalizations | 1325 | 736685 | 1135 | ||
| Age groups (yr) | < 0.001 | < 0.001 | |||
| 18-34 | 30 (2.3) | 36860 (5.0) | 60 (5.3) | ||
| 34-49 | 195 (14.7) | 105475 (14.3) | 205 (18.1) | ||
| 50-64 | 625 (47.2) | 213325 (29.0) | 435 (38.3) | ||
| 65-79 | 375 (28.3) | 242015 (32.9) | 350 (30.8) | ||
| ≥ 80 | 100 (7.5) | 139010 (18.9) | 85 (7.5) | ||
| Gender | < 0.001 | 0.31 | |||
| Male | 930 (70.2) | 380300 (51.6) | 775 (68.3) | ||
| Female | 395 (29.8) | 356385 (48.4) | 360 (31.7) | ||
| Race | < 0.001 | < 0.001 | |||
| White | 580 (43.8) | 388810 (52.8) | 515 (45.4) | ||
| Black | 145 (10.9) | 129635 (17.6) | 180 (15.9) | ||
| Hispanic | 440 (33.2) | 156285 (21.2) | 295 (26.0) | ||
| Asian | 25 (1.9) | 25065 (3.4) | 35 (3.1) | ||
| Native American | 65 (4.9) | 6500 (0.9) | 55 (4.8) | ||
| Other | 70 (5.3) | 30390 (4.1) | 55 (4.8) | ||
| Elixhauser Comorbidity Index score | < 0.001 | < 0.001 | |||
| 0 | 0 (0.0) | 44530 (6.0) | 25 (2.2) | ||
| 1 | 0 (0.0) | 98560 (13.4) | 70 (6.2) | ||
| 2 | 15 (1.1) | 141150 (19.2) | 1040 (91.6) | ||
| ≥ 3 | 1310 (98.9) | 452445 (61.4) | 25 (2.2) | ||
| Region of hospital | < 0.001 | 0.008 | |||
| Northeast | 280 (21.1) | 133450 (18.1) | 245 (21.6) | ||
| Midwest | 250 (18.9) | 168480 (22.9) | 275 (24.2) | ||
| South | 430 (32.5) | 309115 (42.0) | 335 (29.5) | ||
| West | 365 (27.5) | 125640 (17.1) | 280 (24.7) | ||
| Location/teaching status of hospital | < 0.001 | 0.009 | |||
| Rural | 65 (4.9) | 88910 (12.1) | 75 (6.6) | ||
| Urban nonteaching | 180 (13.6) | 147560 (20.0) | 115 (10.1) | ||
| Urban teaching | 1080 (81.5) | 500215 (67.9) | 945 (83.3) | ||
| Primary payer | < 0.001 | 0.030 | |||
| Medicare | 570 (43.0) | 369155 (50.1) | 455 (40.1) | ||
| Medicaid | 420 (31.7) | 93610 (12.7) | 385 (33.9) | ||
| Private | 250 (18.9) | 243440 (33.0) | 245 (21.6) | ||
| Other | 85 (6.4) | 30480 (4.1) | 50 (4.4) | ||
| Median household income national quartile for patient ZIP code | 0.074 | 0.31 | |||
| 1st (0-25th) | 480 (36.2) | 249205 (33.8) | 445 (39.2) | ||
| 2nd (26th-50th) | 335 (25.3) | 203325 (27.6) | 280 (24.7) | ||
| 3rd (51st-75th) | 310 (23.4) | 163695 (22.2) | 235 (20.7) | ||
| 4th (76th-100th) | 200 (15.1) | 120460 (16.4) | 175 (15.4) | ||
| Disposition of patient | < 0.001 | 0.024 | |||
| Discharged to home or self-care (routine discharge) | 685 (51.7) | 445390 (60.5) | 555 (48.9) | ||
| Transfer to short-term hospital | 40 (3.0) | 21910 (3.0) | 20 (1.8) | ||
| Transfer other: Skilled nursing facility, intermediate care facility, or another type of facility | 235 (17.7) | 98350 (13.4) | 205 (18.1) | ||
| Home health care | 120 (9.1) | 99700 (13.5) | 145 (12.8) | ||
| Against medical advice | 50 (3.8) | 7535 (1.0) | 40 (3.5) | ||
| Died during hospitalization | 195 (14.7) | 63625 (8.6) | 170 (15.0) | ||
| Day of admission | 0.43 | 0.27 | |||
| Weekday | 990 (74.7) | 543410 (73.8) | 870 (76.7) | ||
| Weekend | 335 (25.3) | 193275 (26.2) | 265 (23.3) | ||
| Mechanical ventilation | 130 (9.8) | 43865 (6.0) | < 0.001 | 140 (12.3) | 0.046 |
| ICU admission | 140 (10.6) | 43120 (5.9) | < 0.001 | 120 (10.6) | 1.00 |
| Vasopressor requirement | 30 (2.3) | 9345 (1.3) | < 0.001 | 30 (2.6) | 0.54 |
| Age in years at admission, median (IQR) | 60.0 (54.0, 67.0) | 65.0 (53.0, 77.0) | < 0.001 | 61.0 (51.0, 72.0) | 0.65 |
| Length of stay in days, median (IQR) | 5.0 (3.0, 9.0) | 5.0 (3.0, 8.0) | 0.016 | 6.0 (3.0, 11.0) | 0.1 |
| Total hospital charges in USD, median (IQR) | 44739.0 (24963.0, 80405.0) | 39061.0 (22215.0, 71177.0) | < 0.001 | 49862.0 (25884.0, 90286.0) | 0.098 |
Table 2 Inpatient outcomes of coronavirus disease 2019 patients with and without alcohol-associated cirrhosis, n (%)
| Variables | Alcoholic cirrhosis | No alcoholic cirrhosis (before matching) | P value | No alcoholic cirrhosis (after matching) | P value |
| n | 1325 | 736685 | 1135 | ||
| Asthma exacerbation | 5 (0.4) | 13170 (1.8) | < 0.001 | 5 (0.4) | 0.81 |
| ARDS | 80 (6.0) | 31970 (4.3) | 0.002 | 100 (8.8) | 0.008 |
| Type I respiratory failure | 545 (41.1) | 379975 (51.6) | < 0.001 | 475 (41.9) | 0.72 |
| Type II respiratory failure | 15 (1.1) | 7640 (1.0) | 0.73 | 15 (1.3) | 0.67 |
| Bacterial pneumonia | 10 (0.8) | 6005 (0.8) | 0.81 | 10 (0.9) | 0.73 |
| Klebsiella pneumonia | 0 (0.0) | 1425 (0.2) | 0.11 | 0 (0.0) | - |
| Streptococcus pneumonia | 0 (0.0) | 805 (0.1) | 0.23 | 0 (0.0) | - |
| Staphylococcus pneumonia | 5 (0.4) | 3850 (0.5) | 0.46 | 10 (0.9) | 0.11 |
| Hemophilus pneumonia | 5 (0.4) | 300 (< 1) | < 0.001 | 0 (0.0) | - |
| Anosmia | 0 (0.0) | 1240 (0.2) | 0.14 | 0 (0.0) | - |
| Hemorrhagic CVA | 0 (0.0) | 615 (0.1) | 0.29 | 0 (0.0) | - |
| Ischemic CVA | 0 (0.0) | 475 (0.1) | 0.36 | 0 (0.0) | - |
| Dysgeusia | 0 (0.0) | 695 (0.1) | 0.26 | 0 (0.0) | - |
| Diarrhea | 80 (6.0) | 44110 (6.0) | 0.94 | 65 (5.7) | 0.74 |
| Septic shock | 75 (5.7) | 21780 (3.0) | < 0.001 | 47 (4.1) | 0.007 |
| SVT | 30 (2.3) | 9375 (1.3) | 0.001 | 25 (2.2) | 0.92 |
| VT | 20 (1.5) | 10065 (1.4) | 0.65 | 40 (3.5) | 0.001 |
| Vfib/Vflutter | 5 (0.4) | 1315 (0.2) | 0.087 | 0 (0.0) | 0.038 |
| Afib | 175 (13.2) | 77340 (10.5) | 0.001 | 100 (8.8) | < 0.001 |
| Aflutter | 115 (8.7) | 47410 (6.4) | < 0.001 | 50 (4.4) | < 0.001 |
| First-degree AV nodal block | 10 (0.8) | 3250 (0.4) | 0.086 | 0 (0.0) | 0.003 |
| Second-degree AV nodal block | 0 (0.0) | 1515 (0.2) | 0.098 | 0 (0.0) | - |
| Complete AV nodal block | 0 (0.0) | 1375 (0.2) | 0.12 | 10 (0.9) | < 0.001 |
| ECMO | 0 (0.0) | 120 (< 1) | 0.64 | 0 (0.0) | - |
| Total acute VTE | 50 (3.8) | 26120 (3.5) | 0.65 | 75 (6.6) | 0.001 |
| Portal venous thrombosis | 5 (0.4) | 190 (< 1) | < 0.001 | 15 (1.3) | 0.009 |
| Budd Chiari | 0 (0.0) | 35 (< 1) | 0.80 | 0 (0.0) | - |
| Upper extremity VTE | 20 (1.5) | 1960 (0.3) | < 0.001 | 0 (0.0) | < 0.001 |
| Lower extremity VTE | 10 (0.8) | 8050 (1.1) | 0.24 | 10 (0.9) | 0.73 |
| Other VTE | 10 (0.8) | 1285 (0.2) | < 0.001 | 5 (0.4) | 0.32 |
| Pulmonary embolism | 20 (1.5) | 18055 (2.5) | 0.027 | 50 (4.4) | < 0.001 |
| Variceal bleeding | 50 (3.8) | 100 (< 1) | < 0.001 | 0 (0.0) | < 0.001 |
| Hepatorenal syndrome | 5 (0.4) | 140 (< 1) | < 0.001 | 15 (1.3) | 0.009 |
| Hyponatremia | 325 (24.5) | 123080 (16.7) | < 0.001 | 285 (25.1) | 0.74 |
| Pulmonary hypertension | 280 (21.1) | 1210 (0.2) | < 0.001 | 75 (6.6) | < 0.001 |
| Spontaneous bacterial peritonitis | 15 (1.1) | 35 (< 1) | < 0.001 | 5 (0.4) | 0.057 |
| Acute liver failure | 4 (0.34) | 303 (0.45) | < 0.001 | 4 (0.30) | 0.82 |
| New HD | 2 (0.15) | 750 (0.11) | < 0.001 | 0 (0) | 0.1 |
Table 3 Inpatient mortality predictors for coronavirus disease 2019 patients with alcohol-associated cirrhosis (after matching)
| Variables | Odds ratios | P value |
| Alcohol-associated cirrhosis | 0.82 (0.64-1.05) | 0.12 |
| Cardiac arrhythmias | 2.34 (1.38-3.97) | 0.002 |
| Coagulopathy | 1.87 (1.28-2.73) | 0.001 |
| Protein-calorie malnutrition | 5.96 (3.67-9.68) | < 0.001 |
| Fluid and electrolyte disorders | 1.56 (1.05-2.32) | 0.027 |
| Septic shock | 18.77 (10.02-35.13) | < 0.001 |
| Atrial fibrillation | 2.01 (1.11-3.63) | 0.020 |
| Spontaneous bacterial peritonitis | 4.28 (0.91-20.1) | 0.065 |
| Upper extremity venous thromboembolism | 11.38 (3.65-35.46) | < 0.001 |
| Increasing age | 1.06 (1.04-1.07) | < 0.001 |
- Citation: Inayat F, Ali H, Patel P, Dhillon R, Afzal A, Rehman AU, Afzal MS, Zulfiqar L, Nawaz G, Goraya MHN, Subramanium S, Agrawal S, Satapathy SK. Association between alcohol-associated cirrhosis and inpatient complications among COVID-19 patients: A propensity-matched analysis from the United States. World J Virol 2023; 12(4): 221-232
- URL: https://www.wjgnet.com/2220-3249/full/v12/i4/221.htm
- DOI: https://dx.doi.org/10.5501/wjv.v12.i4.221