COVID-19 and chronic liver disease: results from the 1219 patients French registry

The negative impact of Coronavirus SARS CoV-2 related Disease (COVID-19) in patients with chronic liver disease (CLD) has been described in several cohorts. We report here the results from the largest French cohort in “real-life”. The primary outcome was 30-days mortality. Patients with CLD regardless of etiology, who developed COVID-19 confirmed by a positive PCR and/or an evocative chest CT scan were included. The prognostic influence of clinical and biological features was assessed and multivariate analyses were made. Between 08/05/2020 and 31/12/2021, 1219 patients were included, mostly men (62%), median age 61 years, with advanced liver fibrosis in 46%, alcohol-related in 21% of the cases, complicated by liver failure (CHILD-PUGH B/C) in 170 of patients with cirrhosis (40%). Moreover 366 patients (30%) were immunocompromised, including 271 organ transplant recipients. Hospitalization in intensive care unit was required in 11% of the patients and 159 patients (13%) died, 70% of them from extra-hepatic causes. Overall, the independent risk factors for death were age > 61 years, diabetes, advanced liver fibrosis, and alcoholic etiology of the liver disease. Immunosuppression was not a prognostic factor in multivariate analysis. The results of this cohort confirm a significant vulnerability of COVID-19 patients with CLD. On the other hand, they confirm the absence of excess mortality related to immunosuppression, particularly in liver transplant recipients.