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. 2022 Jan;9(1):e000795.
doi: 10.1136/bmjgast-2021-000795.

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Thomas Manship  1 , Paul N Brennan  2 , Iona Campbell  1 , Stewart Campbell  3 , Thomas Clouston  4 , John F Dillon  5   6 , Ewan Forrest  7 , Andrew Fraser  8 , Tee Lin Goh  9 , Michael Johnston  8 , Muhammad I Khan  8 , Victoria Livie  5 , Iain A Murray  10 , Jayne Saunders  11 , Debbie Troland  12 , Ken J Simpson  1
Affiliations

Effect of COVID-19 on presentations of decompensated liver disease in Scotland

Thomas Manship et al. BMJ Open Gastroenterol. 2022 Jan.

Abstract

Background and aims: SARS-CoV-2 and consequent pandemic has presented unique challenges. Beyond the direct COVID-related mortality in those with liver disease, we sought to determine the effect of lockdown on people with liver disease in Scotland. The effect of lockdown on those with alcohol-related disease is of interest; and whether there were associated implications for a change in alcohol intake and consequent presentations with decompensated disease.

Methods: We performed a retrospective analysis of patients admitted to seven Scottish hospitals with a history of liver disease between 1 April and 30 April 2020 and compared across the same time in 2017, 2018 and 2019. We also repeated an intermediate assessment based on a single centre to examine for delayed effects between 1 April and 31 July 2020.

Results: We found that results and outcomes for patients admitted in 2020 were similar to those in previous years in terms of morbidity, mortality, and length of stay. In the Scotland-wide cohort: admission MELD (Model for End-stage Liver Disease) (16 (12-22) vs 15 (12-19); p=0.141), inpatient mortality ((10.9% vs 8.6%); p=0.499) and length of stay (8 days (4-15) vs 7 days (4-13); p=0.140). In the Edinburgh cohort: admission MELD (17 (12-23) vs 17 (13-21); p=0.805), inpatient mortality ((13.7% vs 10.1%; p=0.373) and length of stay (7 days (4-14) vs 7 days (3.5-14); p=0.525)).

Conclusion: This assessment of immediate and medium-term lockdown impacts on those with chronic liver disease suggested a minimal effect on the presentation of decompensated liver disease to secondary care.

Keywords: COVID-19; alcoholic liver disease; liver.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Weekly number of admissions in 2020 compared with the mean number of admissions in the previous 3 years.
See this image and copyright information in PMC

References

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