Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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.

PubMed Disclaimer

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

References

    1. Fenner and White's Medical Virology: coronavirus. Academic Press; 2017. Accessed May 10, 2022. https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-m...
    1. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: emergence, transmission, and characteristics of human coronaviruses. J Adv Res 2020;24:91–8. 10.1016/j.jare.2020.03.005 - DOI - PMC - PubMed
    1. World Health Organization. Coronavirus disease 2019 situation report 51. World Health Organization; 2020. Accessed May 10, 2022. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2...
    1. World Health Organization. WHO Coronavirus (COVID-19) dashboard. World Health Organization; 2021. Accessed May 10, 2022. https://covid19.who.int/
    1. Gao YD, Ding M, Dong X, Zhang JJ, Kursat Azkur A, Azkur D, et al. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy 2021;76(2):428–55. 10.1111/all.14657 - DOI - PubMed