Risk of Severe Illness and Risk Factors of Outcomes of COVID-19 in Hospitalized Patients with Chronic Liver Disease in a Major U. S. Hospital Network

Table 2

Multivariable^∗ Cox proportional hazards model for major outcomes among hospitalized patients with chronic liver disease and a positive test for SARS-CoV-2.

Clinical predictors	All-cause of mortality		Mechanical ventilation		Vasopressors
	Multivariable HR (95% CI)	value	Multivariable HR (95% CI)	value	Multivariable HR (95% CI)	value
Age in years	1.05 (1.04–1.07)	<0.001	1.00 (1.00–1.06)	0.03	0.99 (0.98–1.01)	0.35
Sex
Female	Reference	0.45	Reference	0.43	Reference	0.47
Male	1.13 (0.82–1.55)		1.11 (0.86–1.43)		1.10 (0.84–1.42)
Etiology
ALD	2.75 (0.64–11.85)	0.17	2.79 (1.00–8.02)	0.05	2.27 (0.67–7.61)	0.18
NAFLD	0.21 (0.07–0.65)	0.006	0.54 (0.31–0.93)	0.02	0.66 (0.39–1.14)	0.14
Viral hepatitis	0.22 (0.09–0.50)	<0.001	0.49 (0.32–0.74)	0.001	0.56 (0.37–0.85)	0.007
Other liver diseases	0.36 (0.08–1.56)	0.17	0.36 (0.12–1.03)	0.06	0.44 (0.13–1.48)	0.19
Cirrhosis
No cirrhosis	Reference		Reference		Reference
CC	1.01 (0.13–8.15)	0.99	0.47 (0.10–2.17)	0.32	0.45 (0.10–2.08)	0.31
DC	2.94 (1.23–7.06)	0.02	1.51 (0.96–2.33)	0.07	1.45 (0.93–2.29)	0.11
Comorbidities
CHF	1.13 (0.80–1.60)	0.48	1.75 (0.56–1.00)	0.05	0.78 (0.58–1.06)	0.11
HT	0.75 (0.48–1.17)	0.21	0.80 (0.56–1.13)	0.21	0.83 (0.57–1.21)	0.34
CKD	1.26 (0.87–1.82)	0.22	1.03 (0.77–1.38)	0.83	1.00 (0.74–1.35)	0.98
Diabetes	0.92 (0.65–1.31)	0.64	1.29 (0.98–1.70)	0.07	1.29 (0.96–1.73)	0.09
Chronic pulmonary disease	1.29 (0.92–1.83)	0.13	1.22 (0.93–1.62)	0.15	1.42 (1.07–1.91)	0.01
Chronic neurological disease	1.22 (0.88–1.71)	0.23	0.81 (0.60–1.08)	0.15	0.76 (0.56–1.03)	0.07
Primary malignancy	0.91 (0.62–1.33)	0.61	0.98 (0.68–1.42)	0.93	0.89 (0.61–1.32)	0.56
Metastatic malignancy	1.28 (0.84–1.96)	0.26	0.81 (0.51–1.27)	0.35	1.35 (1.01–1.59)	0.04
ALT	1.00 (1.00–1.00)	0.69	1.00 (0.99–1.00)	0.83	1.00 (1.00–1.00)	0.57
AST	1.00 (1.00–1.00)	0.43	1.00 (1.00–1.00)	0.53	1.00 (1.00–1.00)	0.85
ALP	1.02 (1.00–1.04)	<0.001	1.00 (1.00–1.01)	0.04	1.00 (1.00–1.01)	<0.001
T. Bil	1.25 (1.15–1.37)	<0.001	0.95 (0.76–1.18)	0.64	1.04 (0.89–1.20)	0.64
PT	1.04 (1.01–1.07)	0.007	0.02 (0.99–1.05)	0.19	1.03 (1.00–1.06)	0.07
INR	1.26 (1.01–1.57)	0.04	1.11 (0.88–1.39)	0.39	1.13 (1.09–1.42)	0.29
Neutrophil	1.00(1.00–1.00)	0.007	1.00 (1.00–1.00)	0.006	1.00 (1.00–1.00)	0.002
BUN	1.01 (1.01–1.02)	0.003	1.01 (1.00–1.02)	0.03	1.01 (1.00–1.02)	0.003
CRP	1.05 (1.01–1.14)	0.008	1.00 (1.00–1.00)	0.21	1.00 (1.00–1.00)	0.42
D-Dimer	1.04 (1.01–1.07)	0.02	0.98 (0.95–1.01)	0.27	1.01 (0.98–1.04)	0.47
LDH	1.00 (1.00–1.01)	0.002	1.00 (1.00–1.00)	0.05	1.00 (1.00–1.00)	0.10
Ferritin	1.00 (0.98–1.00)	0.14	1.00 (1.00–1.00)	0.03	1.00 (1.00–1.00)	0.09
ALT
Normal,	Reference		Reference		Reference
1-2 ULN	0.86 (0.57–1.30)	0.48	1.48 (0.95–2.30)	0.08	1.34 (0.84–2.14)	0.22
>2–5 ULN	1.47 (1.29–2.77)	0.003	1.11 (0.73–1.70)	0.62	1.04 (0.66–1.63)	0.87
>5 ULN	1.21 (0.74–1.99)	0.45	1.16 (0.73–1.84)	0.54	1.14 (0.70–1.85)	0.59
AST
Normal,	Reference		Reference		Reference
1-2 ULN	0.94 (0.67–1.33)	0.74	1.17 (0.89–1.53)	0.26	1.32 (1.00–1.76)	0.05
>2–5 ULN	1.92 (1.10–3.34)	0.02	1.69 (1.09–2.61)	0.01	1.55 (0.97–2.50)	0.07
>5 ULN	3.62 (1.52–8.64)	0.004	2.50 (1.12–5.58)	0.02	2.81 (1.18–6.71)	0.02
Bilirubin
Normal	Reference		Reference		Reference
1-2 ULN	1.24 (0.70–2.23)	0.45	1.19 (0.73–1.95)	0.48	1.49 (0.93–2.39)	0.09
>2–5 ULN	2.11 (0.49–9.03)	0.31	0.69 (0.16–2.97)	0.62	0.85 (0.20–3.67)	0.83
>5 ULN	5.21 (0.66–40.91)	0.12	0.00 (IO)	NS	0.00 (IO)	N0
ALP
Normal	Reference		Reference		Reference
1-2 ULN	1.68 (1.12–2.52)	0.01	1.17 (0.84–1.65)	0.36	1.28 (0.90–1.84)	0.17
>2–5 ULN	2.29 (1.10–5.27)	0.05	1.03 (0.41–2.59)	0.94	1.80 (0.81–3.98)	0.15
>5 ULN	2.15 (0.44–10.43)	0.34	0.57 (0.08–4.22)	0.58	1.44 (0.34–6.12)	0.62

Abbreviations: HT, hypertension; CHF, congestive heart failure; CKD, chronic kidney disease; CC, compensated cirrhosis; DC, decompensated cirrhosis; NAFLD, nonalcoholic fatty liver disease; ALD, alcohol-related liver disease; ALT, alanine aminotransferases; ALP, alkaline phosphatase; GGT: γ-glutamyl transpeptidase; AST, aspartate aminotransferase; T-Bil, total bilirubin; INR, international normalized ratio; BUN, blood urea nitrogen; PT, prothrombin time; CRP, C-reactive protein; LDH, lactate dehydrogenase; HR, hazard ratio; CI, confidence interval, IO, insufficient observation. ^∗Age, gender, ethnicity, race, body mass index, smoking use, etiology of liver diseases, and all the pre-existing comorbidities were adjusted as confounders in the multivariable Cox proportional hazards model.