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. 2021 Nov 11;4(4):391-400.
doi: 10.3138/canlivj-2021-0022. eCollection 2021 Fall.

A real-world experience of SARS-CoV-2 infection in a tertiary referral centre of Montréal: Unexpected low prevalence and low mortality

Isaac Ruiz  1 , Geneviève Huard  1 , Claire Fournier  1 , Julien Bissonnette  1 , Hélène Castel  1 , Jeanne-Marie Giard  1 , Jean-Pierre Villeneuve  1 , Daphna Fenyves  1 , Denis Marleau  1 , Bernard Willems  1 , Daniel Corsilli  2 , Florence Correal  3 , Victor Ferreira  3 , Dominic Martel  3 , Alexandre Mathieu  3 , Catherine Vincent  1 , Marc Bilodeau  1
Affiliations

A real-world experience of SARS-CoV-2 infection in a tertiary referral centre of Montréal: Unexpected low prevalence and low mortality

Isaac Ruiz et al. Can Liver J. .

Abstract

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with chronic liver disease (CLD) and liver transplant (LT) recipients remains a concern. The aim of this study was to report the impact of coronavirus disease 2019 (COVID-19) infection among patients at the tertiary health care centre Centre hospitalier de l'Université de Montréal (CHUM) during the first wave of the SARS-CoV-2 pandemic.

Methods: This real-world, retrospective cohort included all patients admitted to our liver unit and/or seen as an outpatient with CLD with or without cirrhosis and/or LT recipients who tested positive to SARS-CoV-2 infection. Cases were considered positive as defined by the detection of SARS-CoV-2 by reverse-transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swabs.

Results: Between April 1 and July 31, 2020, 5,637 were admitted to our liver unit and/or seen as outpatient. Among them, 42 were positive for SARS-CoV-2. Twenty-two patients had CLD without cirrhosis while 16 patients had cirrhosis at the time of the infection (13, 2, and 1 with Child-Pugh A, B, and C scores, respectively). Four were LT recipients. Overall, 15 of 42 patients (35.7%) were hospitalized; among them, 7 of 42 (16.7%) required respiratory support and 4 of 42 (9.5%) were transferred to the intensive care unit. Only 4 of 42 (9.5%) patients died: 2 with CLD without cirrhosis and 2 with CLD with cirrhosis. Overall survival was 90.5%.

Conclusion: This real-world study demonstrates an unexpectedly low prevalence and low mortality in the context of SARS-CoV-2 infection among patients with CLD with or without cirrhosis and LT recipients.

Keywords: COVID-19; SARS-CoV-2; chronic liver disease; cirrhosis; liver transplantation.

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Conflict of interest statement

I Ruiz is a recipient of a fellowship grant from the Fondation du CHUM, Montréal, Québec, Canada. D Martel has served as an advisor and/or speaker for AbbVie and Gilead. The rest of the authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:
Cohort selection Between April 1 and July 31, 2020, 5,637 patients consulted and/or were admitted to the liver unit. Among them, 42 patients were diagnosed with a SARS-CoV-2 infection (prevalence of 0.7%). Of the 42 patients, 22 were diagnosed with CLD without cirrhosis, 16 with CLD and cirrhosis, and 4 had undergone LT. CLD = Chronic liver disease; LT = Liver transplant; SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2; CP = Child–Pugh
Figure 2:
Figure 2:
Clinical course and outcome of SARS-CoV-2 infection Overall, 15/42 (35.7%) of the COVID-19-infected patients were hospitalized. Seven out of 42 (35.7%) needed respiratory support. Four of 42 (9.5%) were transferred to the ICU, and 4/42 (9.5%) died of COVID-19-related complications. CHUM = Centre hospitalier de l’Université de Montréal; SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2; ICU = Intensive care unit; CLD = Chronic liver disease; CP = Child–Pugh; LT = Liver transplan
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