Effect of COVID-19 on presentations of decompensated liver disease in Scotland

TY - JOUR

T1 - Effect of COVID-19 on presentations of decompensated liver disease in Scotland

AU - Manship, Thomas A.

AU - Brennan, Paul N.

AU - Campbell, Iona

AU - Campbell, Stewart

AU - Clouston, Thomas

AU - Dillon, John F.

AU - Forrest, Ewan

AU - Fraser, Andrew

AU - Goh, Tee Lin

AU - Johnston, Michael

AU - Khan, Muhammad I.

AU - Livie, Victoria

AU - Murray, Iain A.

AU - Saunders, Jayne

AU - Troland, Debbie

AU - Simpson, Ken J.

PY - 2022/1/6

Y1 - 2022/1/6

N2 - Background and aims: SARS-CoV-2 and consequent pandemic has presented unique challenges. Beyond the direct COVID-related mortality in those with liver disease, we sought to determine the effect of lockdown on people with liver disease in Scotland. The effect of lockdown on those with alcohol-related disease is of interest; and whether there were associated implications for a change in alcohol intake and consequent presentations with decompensated disease. Methods: We performed a retrospective analysis of patients admitted to seven Scottish hospitals with a history of liver disease between 1 April and 30 April 2020 and compared across the same time in 2017, 2018 and 2019. We also repeated an intermediate assessment based on a single centre to examine for delayed effects between 1 April and 31 July 2020. Results: We found that results and outcomes for patients admitted in 2020 were similar to those in previous years in terms of morbidity, mortality, and length of stay. In the Scotland-wide cohort: admission MELD (Model for End-stage Liver Disease) (16 (12–22) vs 15 (12–19); p=0.141), inpatient mortality ((10.9% vs 8.6%); p=0.499) and length of stay (8 days (4–15) vs 7 days (4–13); p=0.140). In the Edinburgh cohort: admission MELD (17 (12–23) vs 17 (13–21); p=0.805), inpatient mortality ((13.7% vs 10.1%; p=0.373) and length of stay (7 days (4–14) vs 7 days (3.5–14); p=0.525)). Conclusion: This assessment of immediate and medium-term lockdown impacts on those with chronic liver disease suggested a minimal effect on the presentation of decompensated liver disease to secondary care.

AB - Background and aims: SARS-CoV-2 and consequent pandemic has presented unique challenges. Beyond the direct COVID-related mortality in those with liver disease, we sought to determine the effect of lockdown on people with liver disease in Scotland. The effect of lockdown on those with alcohol-related disease is of interest; and whether there were associated implications for a change in alcohol intake and consequent presentations with decompensated disease. Methods: We performed a retrospective analysis of patients admitted to seven Scottish hospitals with a history of liver disease between 1 April and 30 April 2020 and compared across the same time in 2017, 2018 and 2019. We also repeated an intermediate assessment based on a single centre to examine for delayed effects between 1 April and 31 July 2020. Results: We found that results and outcomes for patients admitted in 2020 were similar to those in previous years in terms of morbidity, mortality, and length of stay. In the Scotland-wide cohort: admission MELD (Model for End-stage Liver Disease) (16 (12–22) vs 15 (12–19); p=0.141), inpatient mortality ((10.9% vs 8.6%); p=0.499) and length of stay (8 days (4–15) vs 7 days (4–13); p=0.140). In the Edinburgh cohort: admission MELD (17 (12–23) vs 17 (13–21); p=0.805), inpatient mortality ((13.7% vs 10.1%; p=0.373) and length of stay (7 days (4–14) vs 7 days (3.5–14); p=0.525)). Conclusion: This assessment of immediate and medium-term lockdown impacts on those with chronic liver disease suggested a minimal effect on the presentation of decompensated liver disease to secondary care.

KW - COVID-19

KW - alcoholic liver disease

KW - liver

UR - https://www.scopus.com/pages/publications/85122921199

U2 - 10.1136/bmjgast-2021-000795

DO - 10.1136/bmjgast-2021-000795

M3 - Article

C2 - 34992071

SN - 2054-4774

VL - 9

JO - BMJ Open Gastroenterology

JF - BMJ Open Gastroenterology

IS - 1

M1 - e000795

ER -