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1. Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

Author

Sarin, Shiv Kumar, primary, Choudhury, Ashok, additional, Lau, George K, additional, Zheng, Ming-Hua, additional, Ji, Dong, additional, Abd-Elsalam, Sherief, additional, Hwang, Jaeseok, additional, Qi, Xiaolong, additional, Cua, Ian Homer, additional, Suh, Jeong Ill, additional, Park, Jun Gi, additional, Putcharoen, Opass, additional, Kaewdech, Apichat, additional, Piratvisuth, Teerha, additional, Treeprasertsuk, Sombat, additional, Park, Sooyoung, additional, Wejnaruemarn, Salisa, additional, Payawal, Diana A., additional, Baatarkhuu, Oidov, additional, Ahn, Sang Hoon, additional, Yeo, Chang Dong, additional, Alonzo, Uzziel Romar, additional, Chinbayar, Tserendorj, additional, Loho, Imelda M., additional, Yokosuka, Osamu, additional, Jafri, Wasim, additional, Tan, Soeksiam, additional, Soo, Lau Ing, additional, Tanwandee, Tawesak, additional, Gani, Rino, additional, Anand, Lovkesh, additional, Esmail, Eslam Saber, additional, Khalaf, Mai, additional, Alam, Shahinul, additional, Lin, Chun-Yu, additional, Chuang, Wan-Long, additional, Soin, A S, additional, Garg, Hitendra K, additional, Kalista, Kemal, additional, Batsukh, Badamnachin, additional, Purnomo, Hery Djagat, additional, Dara, Vijay Pal, additional, Rathi, Pravin, additional, Mahtab, Mamun Al, additional, Shukla, Akash, additional, Sharma, Manoj K, additional, and Omata, Masao, additional

Published
2020
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2. Pre-Existing Liver Disease Is Associated with Poor Outcome in Patients with SARS CoV-2 Infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

Author

Sarin, Shiv Kumar, primary, Choudhury, Ashok, additional, Lau, George, additional, Zheng, Ming-Hua, additional, Ji, Dong, additional, Abd-Elsalam, Sherief, additional, Hwang, Jaeseok, additional, Qi, Xiaolong, additional, Cua, Ian Homer, additional, Suh, Jeong Ill, additional, Putcharoen, Opass, additional, Kaewdech, Apichat, additional, Piratvisuth, Teerha, additional, Treeprasertsuk, Sombat, additional, Park, Sooyoung, additional, Wejnaruemarn, Salisa, additional, Payawal, Diana A., additional, Baatarkhuu, Oidov, additional, Ahn, Sang Hoon, additional, Yeo, Chang Dong, additional, Alonzo, Uzziel Romar, additional, Chinbayar, Tserendorj, additional, Loho, Imelda M., additional, Yokosuka, Osamu, additional, Jafri, Wasim, additional, Tan, Soeksiam, additional, Soo, Lau Ing, additional, Tanwandee, Tawesak, additional, Gani, Rino, additional, Anand, Lovkesh, additional, Esmail, Eslam Saber, additional, Khalaf, Mai, additional, Alam, Shahinul, additional, Lin, Chun-Yu, additional, Chuang, Wan-Long, additional, Soin, Arvinder Singh, additional, Garg, Hitendra K., additional, Kalista, Kemal, additional, Batsukh, Badamnachin, additional, Purnomo, Hery Djagat, additional, Dara, Vijay Pal, additional, Rathi, Pravin, additional, Mahtab, Mamun Al, additional, Shukla, Akash, additional, Sharma, Manoj K., additional, Omata, Masao, additional, Task Force, APASL COVID, additional, and Spectrum Study, APASL COVID Liver Injury, additional

Published
2020
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3. APCOLIS SCORE PREDICTS OUTCOME IN PATIENTS OF CIRRHOSIS WITH SARS-COV-2 INFECTION- DATA FROM ONGOING APASL COVID LIVER INJURY SPECTRUM (APCOLIS-I) STUDY

Author

Choudhury, Ashok Kumar, Zheng, Ming-Hua, Lau, George, Dong Ji, Shasthry, S. M., Jindal, Ankur, Maiwall, Rakhi, Thomas, Noble, Abd-Elsalam, Sherief, Suh, Jeong, Hwang, Jaeseok, Qi, Xiaolong, Cua, Ian Homer Y., Putcharoen, Opass, Park, Soo Young, Kaewdech, Apichat, Piratvisuth, Teerha, Treeprasertsuk, Sombat, Wejnaruemarn, Salisa, Al Mahtab, Mamun, Akbar, Sheikh Mohamed Fazle, Distefano, Marco, Tan, Soeksiam, Hamid, Saeed S., Subhan, Amna, Loho, Imelda M., Esmail, Eslam Saber, Payawal, Diana A., Yeo, Chang Dong, Oidov, Baatarkhuu, Ahn, Sang Hoon, Tserendorj, Chinbayar, Romar Alonzo, Uzziel, Yokosuka, Osamu, Tanwandee, Tawesak, Rathi, Pravin, Soin, Arvinder Singh, Shukla, Akash, Batsukh, Badamnachin, Kalal, Chetan Ramesh, Jafri, Syed Muhammad Wasim, Lee, Guan Huei, Goyal, Omesh, Purnomo, Hery Djagat, Kalista, Kemal Fariz, Khalef, Mai, Parewangi, Muhammad Luthfi, Das, Nihar Ranjan, Gani, Rino A., Alam, Mohd Shahinul, Chuang, Wan-Long, Anand, Lovkesh, Sharma, Manoj K., Omata, Masao, and Sarin, Shiv Kumar

4. Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study).

Author

Sarin SK, Choudhury A, Lau GK, Zheng MH, Ji D, Abd-Elsalam S, Hwang J, Qi X, Cua IH, Suh JI, Park JG, Putcharoen O, Kaewdech A, Piratvisuth T, Treeprasertsuk S, Park S, Wejnaruemarn S, Payawal DA, Baatarkhuu O, Ahn SH, Yeo CD, Alonzo UR, Chinbayar T, Loho IM, Yokosuka O, Jafri W, Tan S, Soo LI, Tanwandee T, Gani R, Anand L, Esmail ES, Khalaf M, Alam S, Lin CY, Chuang WL, Soin AS, Garg HK, Kalista K, Batsukh B, Purnomo HD, Dara VP, Rathi P, Al Mahtab M, Shukla A, Sharma MK, and Omata M

Subjects
Asia epidemiology, Betacoronavirus isolation & purification, COVID-19, Disease Progression, Female, Humans, Liver Function Tests methods, Liver Function Tests statistics & numerical data, Male, Middle Aged, Patient Acuity, Prognosis, Risk Assessment, Risk Factors, SARS-CoV-2, Acute-On-Chronic Liver Failure diagnosis, Acute-On-Chronic Liver Failure virology, Coronavirus Infections epidemiology, Coronavirus Infections physiopathology, Coronavirus Infections therapy, Liver Cirrhosis diagnosis, Liver Cirrhosis epidemiology, Liver Cirrhosis etiology, Pandemics, Pneumonia, Viral epidemiology, Pneumonia, Viral physiopathology, Pneumonia, Viral therapy
Abstract

Background and Aims: COVID-19 is a dominant pulmonary disease, with multisystem involvement, depending upon comorbidities. Its profile in patients with pre-existing chronic liver disease (CLD) is largely unknown. We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis., Methods: Data was collected from 13 Asian countries on patients with CLD, known or newly diagnosed, with confirmed COVID-19., Results: Altogether, 228 patients [185 CLD without cirrhosis and 43 with cirrhosis] were enrolled, with comorbidities in nearly 80%. Metabolism associated fatty liver disease (113, 61%) and viral etiology (26, 60%) were common. In CLD without cirrhosis, diabetes [57.7% vs 39.7%, OR = 2.1 (1.1-3.7), p = 0.01] and in cirrhotics, obesity, [64.3% vs. 17.2%, OR = 8.1 (1.9-38.8), p = 0.002] predisposed more to liver injury than those without these. Forty three percent of CLD without cirrhosis presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure [5 (11.6%)] or acute decompensation [4 (9%)]. Liver related complications increased (p < 0.05) with stage of liver disease; a Child-Turcotte Pugh score of 9 or more at presentation predicted high mortality [AUROC 0.94, HR = 19.2 (95 CI 2.3-163.3), p < 0.001, sensitivity 85.7% and specificity 94.4%). In decompensated cirrhotics, the liver injury was progressive in 57% patients, with 43% mortality. Rising bilirubin and AST/ALT ratio predicted mortality among cirrhosis patients., Conclusions: SARS-Cov-2 infection causes significant liver injury in CLD patients, decompensating one fifth of cirrhosis, and worsening the clinical status of the already decompensated. The CLD patients with diabetes and obesity are more vulnerable and should be closely monitored.

Published
2020
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