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Meta-Analysis
. 2022 Aug 25:19:E53.
doi: 10.5888/pcd19.210228.

COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis

Ramya Nagarajan  1 , Yuvaraj Krishnamoorthy  2 , Sathish Rajaa  2 , Vishnu Shankar Hariharan  3
Affiliations
Meta-Analysis

COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis

Ramya Nagarajan et al. Prev Chronic Dis. .

Abstract

Introduction: Pre-existing comorbid conditions in COVID-19 patients are risk factors for developing severe disease and death. We aimed to determine the association of chronic liver disease (CLD), a comorbid condition, with severity of disease and death among COVID-19 patients.

Methods: We searched for studies reporting COVID-19 outcomes among CLD and non-CLD patients in databases including Medline, EMBASE, ScienceDirect, Google Scholar, and Cochrane Library from inception of the pandemic until February 2022. Risk of bias assessment was conducted by using the Newcastle-Ottawa Scale for assessing the quality of nonrandomized studies in meta-analyses. We conducted a meta-analysis with a random-effects model and reported pooled odds ratios (ORs) with 95% CIs.

Results: We included 40 studies with 908,032 participants. Most studies were conducted in China and the US. COVID-19 patients with CLD had significantly higher odds of having a severe form of COVID-19 (pooled OR = 2.44; 95% CI, 1.89-3.16) and death (pooled OR = 2.35; 95% CI, 1.85-3.00) when compared with COVID-19 patients without CLD.

Conclusion: The presence of CLD is significantly related to adverse clinical outcomes among COVID-19 patients in terms of severity and mortality. Clinicians should develop a comprehensive intervention plan to manage these high-risk patients and reduce COVID-19-related deaths.

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Figures

Figure 1
Figure 1
PRISMA flowchart showing the identification of studies for analysis of the association of chronic liver disease with severity of disease and mortality among COVID-19 patients. Abbreviation: PRISMA, Preferred Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
Forest plot showing the difference in severity between COVID-19 patients with and without CLD (N = 27). Abbreviation: CLD, chronic liver disease.
Figure 3
Figure 3
Forest plot showing the difference in mortality between COVID-19 patients with and without chronic liver disease (CLD) (N = 27).
See this image and copyright information in PMC

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