TY - JOUR
T1 - Decreasing Case Fatality Rates for Patients With Cirrhosis Infected With SARS-CoV-2
T2 - A National COVID Cohort Collaborative Study
AU - National COVID Cohort Collaborative (N3C) Consortium
AU - Ge, Jin
AU - Far, Aryana T.
AU - Digitale, Jean C.
AU - Pletcher, Mark J.
AU - Lai, Jennifer C.
AU - Wilcox, Adam B.
AU - Lee, Adam M.
AU - Graves, Alexis
AU - Anzalone, Alfred (Jerrod)
AU - Manna, Amin
AU - Saha, Amit
AU - Olex, Amy
AU - Zhou, Andrea
AU - Williams, Andrew E.
AU - Southerland, Andrew
AU - Girvin, Andrew T.
AU - Walden, Anita
AU - Sharathkumar, Anjali A.
AU - Amor, Benjamin
AU - Bates, Benjamin
AU - Hendricks, Brian
AU - Patel, Brijesh
AU - Alexander, Caleb
AU - Bramante, Carolyn
AU - Ward-Caviness, Cavin
AU - Madlock-Brown, Charisse
AU - Suver, Christine
AU - Chute, Christopher
AU - Dillon, Christopher
AU - Wu, Chunlei
AU - Schmitt, Clare
AU - Takemoto, Cliff
AU - Housman, Dan
AU - Gabriel, Davera
AU - Eichmann, David A.
AU - Mazzotti, Diego
AU - Brown, Don
AU - Boudreau, Eilis
AU - Hill, Elaine
AU - Zampino, Elizabeth
AU - Marti, Emily Carlson
AU - Pfaff, Emily R.
AU - French, Evan
AU - Koraishy, Farrukh M.
AU - Mariona, Federico
AU - Prior, Fred
AU - Sokos, George
AU - Martin, Greg
AU - Lehmann, Harold
AU - Spratt, Heidi
AU - Mehta, Hemalkumar
AU - Liu, Hongfang
AU - Sidky, Hythem
AU - Hayanga, J. W.Awori
AU - Pincavitch, Jami
AU - Clark, Jaylyn
AU - Harper, Jeremy Richard
AU - Islam, Jessica
AU - Gagnier, Joel
AU - Saltz, Joel H.
AU - Saltz, Joel
AU - Loomba, Johanna
AU - Buse, John
AU - Mathew, Jomol
AU - Rutter, Joni L.
AU - McMurry, Julie A.
AU - Guinney, Justin
AU - Starren, Justin
AU - Crowley, Karen
AU - Bradwell, Katie Rebecca
AU - Walters, Kellie M.
AU - Wilkins, Ken
AU - Gersing, Kenneth R.
AU - Cato, Kenrick Dwain
AU - Murray, Kimberly
AU - Kostka, Kristin
AU - Northington, Lavance
AU - Pyles, Lee Allan
AU - Misquitta, Leonie
AU - Cottrell, Lesley
AU - Portilla, Lili
AU - Deacy, Mariam
AU - Bissell, Mark M.
AU - Clark, Marshall
AU - Emmett, Mary
AU - Saltz, Mary Morrison
AU - Palchuk, Matvey B.
AU - Haendel, Melissa A.
AU - Adams, Meredith
AU - Temple-O'Connor, Meredith
AU - Kurilla, Michael G.
AU - Morris, Michele
AU - Qureshi, Nabeel
AU - Safdar, Nasia
AU - Garbarini, Nicole
AU - Sharafeldin, Noha
AU - Sadan, Ofer
AU - Francis, Patricia A.
AU - Burgoon, Penny Wung
AU - Robinson, Peter
AU - Payne, Philip R.O.
AU - Fuentes, Rafael
AU - Jawa, Randeep
AU - Erwin-Cohen, Rebecca
AU - Patel, Rena
AU - Moffitt, Richard A.
AU - Zhu, Richard L.
AU - Kamaleswaran, Rishi
AU - Hurley, Robert
AU - Miller, Robert T.
AU - Pyarajan, Saiju
AU - Michael, Sam G.
AU - Bozzette, Samuel
AU - Mallipattu, Sandeep
AU - Vedula, Satyanarayana
AU - Chapman, Scott
AU - O'Neil, Shawn T.
AU - Setoguchi, Soko
AU - Hong, Stephanie S.
AU - Johnson, Steve
AU - Bennett, Tellen D.
AU - Callahan, Tiffany
AU - Topaloglu, Umit
AU - Sheikh, Usman
AU - Gordon, Valery
AU - Subbian, Vignesh
AU - Kibbe, Warren A.
AU - Hernandez, Wenndy
AU - Beasley, Will
AU - Cooper, Will
AU - Hillegass, William
AU - Zhang, Xiaohan Tanner
N1 - Publisher Copyright:
© 2024 AGA Institute
PY - 2024
Y1 - 2024
N2 - Background & Aims: The virulence and severity of SARS-CoV-2 infections have decreased over time in the general population due to vaccinations and improved antiviral treatments. Whether a similar trend has occurred in patients with cirrhosis is unclear. We used the National COVID Cohort Collaborative (N3C) to describe the outcomes over time. Methods: We utilized the N3C level 3 data set with uncensored dates to identify all patients with chronic liver disease (CLD) with and without cirrhosis who had SARS-CoV-2 infection as of November 2023. We described the observed 30-day case fatality rate (CFR) by month of infection. We used adjusted survival analyses to calculate relative hazard of death by month of infection compared with infection at the onset of the COVID-19 pandemic. Results: We identified 117,811 total patients with CLD infected with SARS-CoV-2 between March 2020 and November 2023: 27,428 (23%) with cirrhosis and 90,383 (77%) without cirrhosis. The observed 30-day CFRs during the entire study period were 1.1% (1016) for patients with CLD without cirrhosis and 6.3% (1732) with cirrhosis. Observed 30-day CFRs by month of infection varied throughout the pandemic and showed a sustained downward trend since 2022. Compared with infection in Quarter 2 of 2020 (at the beginning of the pandemic), the adjusted hazards of death at 30 days for infection in Quarter 3 of 2023 were 0.20 (95% confidence interval [CI], 0.08–0.50) for patients with CLD without cirrhosis and 0.35 (95% CI, 0.18–0.69) for patients with CLD with cirrhosis. Conclusions: In this N3C study, we found that the observed 30-day CFR decreased progressively for patients with CLD both with and without cirrhosis, consistent with broader trends seen in the general population.
AB - Background & Aims: The virulence and severity of SARS-CoV-2 infections have decreased over time in the general population due to vaccinations and improved antiviral treatments. Whether a similar trend has occurred in patients with cirrhosis is unclear. We used the National COVID Cohort Collaborative (N3C) to describe the outcomes over time. Methods: We utilized the N3C level 3 data set with uncensored dates to identify all patients with chronic liver disease (CLD) with and without cirrhosis who had SARS-CoV-2 infection as of November 2023. We described the observed 30-day case fatality rate (CFR) by month of infection. We used adjusted survival analyses to calculate relative hazard of death by month of infection compared with infection at the onset of the COVID-19 pandemic. Results: We identified 117,811 total patients with CLD infected with SARS-CoV-2 between March 2020 and November 2023: 27,428 (23%) with cirrhosis and 90,383 (77%) without cirrhosis. The observed 30-day CFRs during the entire study period were 1.1% (1016) for patients with CLD without cirrhosis and 6.3% (1732) with cirrhosis. Observed 30-day CFRs by month of infection varied throughout the pandemic and showed a sustained downward trend since 2022. Compared with infection in Quarter 2 of 2020 (at the beginning of the pandemic), the adjusted hazards of death at 30 days for infection in Quarter 3 of 2023 were 0.20 (95% confidence interval [CI], 0.08–0.50) for patients with CLD without cirrhosis and 0.35 (95% CI, 0.18–0.69) for patients with CLD with cirrhosis. Conclusions: In this N3C study, we found that the observed 30-day CFR decreased progressively for patients with CLD both with and without cirrhosis, consistent with broader trends seen in the general population.
KW - COVID-19
KW - Chronic Liver Disease
KW - Cirrhosis
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85204741729&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2024.07.028
DO - 10.1016/j.cgh.2024.07.028
M3 - Article
C2 - 39181420
AN - SCOPUS:85204741729
SN - 1542-3565
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
ER -