The impact of the COVID-19 pandemic on patients with chronic liver disease: Results from the Global Liver Registry

• Main Authors: Younossi, Zobair M., Yilmaz, Yusuf, El-Kassas, Mohamed, Duseja, Ajay, Hamid, Saeed, Esmat, Gamal, Mendez-Sanchez, Nahum, Chan, Wah Kheong, Singal, Ashwani K., Lam, Brian, Felix, Sean, Younossi, Elena, Verma, Manisha, Price, Jillian K., Nader, Fatema, Younossi, Issah, Racila, Andrei, Stepanova, Maria
• Format: Article
• Published: John Wiley & Sons Ltd 2022
• Subjects: RA Public aspects of medicine
• Online Access: http://eprints.um.edu.my/41220/

Patients with preexisting chronic liver disease (CLD) may experience a substantial burden from both coronavirus 2019 (COVID-19) infection and pandemic-related life disruption. We assessed the impact of the COVID-19 pandemic on patients with CLD. Patients enrolled in our Global Liver Registry were invited to complete a COVID-19 survey. As of June 2021, 2500 patients (mean age +/- SD, 49 +/- 13 years; 53% men) from seven countries completed the survey. Of all survey completers, 9.3% had COVID-19. Of these patients, 19% were hospitalized, 13% needed oxygen support, but none required mechanical ventilation. Of all patients including those not infected with COVID-19, 11.3% reported that the pandemic had an impact on their liver disease, with 73% of those reporting delays in follow-up care. The Life Disruption Event Perception questionnaire confirmed worsening in at least one area (food/nutrition, exercise, social life, vocation/education, financial situation, housing, or health care) in 81% and 69% of patients with and without a history of COVID-19, respectively (p = 0.0001). On a self-assessed Likert health score scale (range, 1-10; 10 indicates perfect health), patients with a COVID-19 history scored lower (mean +/- SD, 6.7 +/- 2.2 vs. 7.4 +/- 2.2, respectively; p < 0.0001) despite reporting similar health scores if there was no pandemic (mean +/- SD, 8.5 +/- 1.4 vs. 8.4 +/- 1.6, respectively; p = 0.59). After adjustment for country of enrollment, liver disease etiology and severity, age, sex, body mass index, diabetes, and history of psychiatric comorbidities, COVID-19 was found to be independently associated with lower self-assessed health scores (beta = -0.71 +/- 0.14; p < 0.0001). The COVID-19 pandemic resulted in a substantial burden on the daily life of patients with CLD.