NEW DELHI: A new research from AIIMS, Delhi has shown that the highest mortality rate in Covid-19 patients is among those who have had pre-existing chronic liver diseases. These patients fare even far worse than those with other comorbidities such as hypertension and diabetes.
The mortality rate among people suffering from serious liver ailments was found to be over 42% by researchers associated with the country's top government medical institution.
The mortality rate due to the infection in patients with other pre-existing illnesses, on the other hand, has been found to be up to 30 %.
The study, published in the Indian Journal of Gastroenterology, is based on the assessment of 28 patients, out of a total of 750 Covid-19 patients in the hospital between April 22 to June 22, with known chronic liver diseases. Seventy-eight cirrhotic patients without COVID-19 were included as historical controls for comparison.
Of the total 28 Covid-19 patients with liver complications, two were without cirrhosis, one was with compensated cirrhosis, sixteen with acute decompensation and nine had acute-on-chronic liver failure.
The mortality rate in Covid-19 patients with these complications was 42.3% as compared to 23.1% in the historical controls, the researchers found and all infected patients with acute-on-chronic liver failure died.
Mortality rate was also higher in Covid-19 patients with compensated cirrhosis and acute decompensation.
Both non-cirrhotic patients presented with respiratory symptoms, however, recovered uneventfully.
Based on these results, the study has noted that "patients with cirrhosis and Covid-19 have poor outcomes as compared with those without Covid-19. "The survival rates are the worst among those with acute-on-chronic liver failure."
The study said that while liver enzyme derangements are common and seen in 14% to 53% of Covid-19 cases, the clinical consequences are not well known in patients without liver disease since the majority of these derangements are mild in nature and hence clinically inconsequential.
"However, their impact on patients with underlying liver diseases is beginning to emerge," it said.
Evolving data from a global registry suggest a poor outcome in patients with cirrhosis. Among these, 45% presented with new decompensation and the mortality rate was 33%. In contrast, 303 patients with chronic liver disease without cirrhosis fared better with a mortality rate of 8%, the study noted.
These results from a tertiary care centre in India assume significance as the understanding around the complications due to Covid-19 is still evolving.
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