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Multicenter Study
. 2021 Dec;12(1):1199-1208.
doi: 10.1080/21505594.2021.1909894.

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

Yong Xiao  1 , Dongwen Wu  2 , Xiao Shi  2 , Shuzhong Liu  1 , Xudong Hu  3 , Chenliang Zhou  4 , Xia Tian  5 , Huimin Liu  6 , Hui Long  7 , Zhihong Li  8 , Ji Wang  9 , Tao Tan  10 , Ying Xu  11 , Bitao Chen  12 , Ting Liu  13 , Heng Zhang  14 , Shihua Zheng  15 , Shunlin Hu  16 , Jun Song  17 , Jie Tang  18 , Jichun Song  19 , Zhengwei Cheng  20 , Weitian Xu  21 , Yongxiang Shen  22 , Wenhu Yu  23 , Yong Xu  24 , Jiao Li  1 , Jing Zhou  1 , Fen Wang  2 , Mingkai Chen  1
Affiliations
Multicenter Study

High Child-Pugh and CRUB65 scores predict mortality of decompensated cirrhosis patients with COVID-19: A 23-center, retrospective study

Yong Xiao et al. Virulence. 2021 Dec.

Abstract

Background: COVID-19 has rapidly become a major health emergency worldwide. The characteristic, outcome, and risk factor of COVID-19 in patients with decompensated cirrhosis remain unclear.Methods: Medical records were collected from 23 Chinese hospitals. Patients with decompensated cirrhosis and age- and sex-matched non-liver disease patients were enrolled with 1:4 ratio using stratified sampling.Results: There were more comorbidities with higher Chalson Complication Index (p < 0.001), higher proportion of patients having gastrointestinal bleeding, jaundice, ascites, and diarrhea among those patients (p < 0.05) and in decompensated cirrhosis patients. Mortality (p < 0.05) and the proportion of severe ill (p < 0.001) were significantly high among those patients. Patients in severe ill subgroup had higher mortality (p < 0.001), MELD, and CRUB65 score but lower lymphocytes count. Besides, this subgroup had larger proportion of patients with abnormal (PT), activated partial thromboplatin time (APTT), D-Dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBL) and Creatinine (Cr) (p < 0.05). Multivariate logistic regression for severity shown that MELD and CRUB65 score reached significance. Higher Child-Pugh and CRUB65 scores were found among non-survival cases and multivariate logistic regression further inferred risk factors for adverse outcome. Receiver Operating Characteristic (ROC) curves also provided remarkable demonstrations for the predictive ability of Child-Pugh and CRUB65 scores.Conclusions: COVID-19 patients with cirrhosis had larger proportion of more severely disease and higher mortality. MELD and CRUB65 score at hospital admission may predict COVID-19 severity while Child-Pugh and CRUB65 score were highly associated with non-survival among those patients.

Keywords: COVID-19; decompensated cirrhosis; risk factor.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Age and gender distribution of patients
Figure 2.
Figure 2.
Receiver Operating Characteristic (ROC) curves analysis for CRUB65 and Child-Pugh scores including the area under the curve (AUC) and P-value
See this image and copyright information in PMC

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