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Article: Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease
Title | Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease |
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Authors | |
Keywords | Chronic liver disease Cirrhosis Hepatocellular carcinoma Long COVID Post-COVID-19 syndrome SARS-CoV-2 infection |
Issue Date | 27-Feb-2024 |
Publisher | Baishideng Publishing Group |
Citation | World Journal of Hepatology, 2024, v. 16, n. 2, p. 211-228 How to Cite? |
Abstract | BACKGROUND Chronic liver disease (CLD) was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. AIM To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma (HCC) among patients with CLD. METHODS A retrospective, territory-wide cohort of CLD patients was identified from an electronic health database in Hong Kong. Patients with confirmed SARS-CoV-2 infection [coronavirus disease 2019 (COVID-19)+CLD] between January 1, 2020 and October 25, 2022 were identified and matched 1:1 by propensity-score with those without (COVID-19-CLD). Each patient was followed up until death, outcome event, or November 15, 2022. Primary outcome was incidence of HCC. Secondary outcomes included all-cause mortality, adverse hepatic outcomes, and different treatment strategies to HCC (curative, non-curative treatment, and palliative care). Analyses were further stratified by acute (within 20 d) and post-acute (21 d or beyond) phases of SARS-CoV-2 infection. Incidence rate ratios (IRRs) were estimated by Poisson regression models. RESULTS Of 193589 CLD patients (> 95% non-cirrhotic) in the cohort, 55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score matching. Upon 249-d median follow-up, COVID-19+CLD was not associated with increased risk of incident HCC (IRR: 1.19, 95%CI: 0.99-1.42, P = 0.06), but higher risks of receiving palliative care for HCC (IRR: 1.60, 95%CI: 1.46-1.75, P < 0.001), compared to COVID-19- CLD. In both acute and post-acute phases of infection, COVID-19+CLD were associated with increased risks of all-cause mortality (acute: IRR: 7.06, 95%CI: 5.78-8.63, P < 0.001; post-acute: IRR: 1.24, 95%CI: 1.14-1.36, P < 0.001) and adverse hepatic outcomes (acute: IRR: 1.98, 95%CI: 1.79-2.18, P < 0.001; post-acute: IRR: 1.24, 95%CI: 1.13-1.35, P < 0.001), compared to COVID-19-CLD. CONCLUSION Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC, they were more likely to receive palliative treatment than those without. The detrimental effects of SARS-CoV-2 infection persisted in post-acute phase. |
Persistent Identifier | http://hdl.handle.net/10722/345639 |
ISSN | 2023 Impact Factor: 2.5 2023 SCImago Journal Rankings: 0.673 |
DC Field | Value | Language |
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dc.contributor.author | Mak, Lung Yi | - |
dc.contributor.author | Chung, Matthew Shing Hin | - |
dc.contributor.author | Li, Xue | - |
dc.contributor.author | Lai, Francisco Tsz Tsun | - |
dc.contributor.author | Wan, Eric Yuk Fai | - |
dc.contributor.author | Chui, Celine Sze Ling | - |
dc.contributor.author | Cheng, Franco Wing Tak | - |
dc.contributor.author | Chan, Esther Wai Yin | - |
dc.contributor.author | Cheung, Ching Lung | - |
dc.contributor.author | Au, Ivan Chi Ho | - |
dc.contributor.author | Xiong, Xi | - |
dc.contributor.author | Seto, Wai Kay | - |
dc.contributor.author | Yuen, Man Fung | - |
dc.contributor.author | Wong, Carlos King Ho | - |
dc.contributor.author | Wong, Ian Chi Kei | - |
dc.date.accessioned | 2024-08-27T09:10:10Z | - |
dc.date.available | 2024-08-27T09:10:10Z | - |
dc.date.issued | 2024-02-27 | - |
dc.identifier.citation | World Journal of Hepatology, 2024, v. 16, n. 2, p. 211-228 | - |
dc.identifier.issn | 1948-5182 | - |
dc.identifier.uri | http://hdl.handle.net/10722/345639 | - |
dc.description.abstract | BACKGROUND Chronic liver disease (CLD) was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. AIM To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma (HCC) among patients with CLD. METHODS A retrospective, territory-wide cohort of CLD patients was identified from an electronic health database in Hong Kong. Patients with confirmed SARS-CoV-2 infection [coronavirus disease 2019 (COVID-19)+CLD] between January 1, 2020 and October 25, 2022 were identified and matched 1:1 by propensity-score with those without (COVID-19-CLD). Each patient was followed up until death, outcome event, or November 15, 2022. Primary outcome was incidence of HCC. Secondary outcomes included all-cause mortality, adverse hepatic outcomes, and different treatment strategies to HCC (curative, non-curative treatment, and palliative care). Analyses were further stratified by acute (within 20 d) and post-acute (21 d or beyond) phases of SARS-CoV-2 infection. Incidence rate ratios (IRRs) were estimated by Poisson regression models. RESULTS Of 193589 CLD patients (> 95% non-cirrhotic) in the cohort, 55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score matching. Upon 249-d median follow-up, COVID-19+CLD was not associated with increased risk of incident HCC (IRR: 1.19, 95%CI: 0.99-1.42, P = 0.06), but higher risks of receiving palliative care for HCC (IRR: 1.60, 95%CI: 1.46-1.75, P < 0.001), compared to COVID-19- CLD. In both acute and post-acute phases of infection, COVID-19+CLD were associated with increased risks of all-cause mortality (acute: IRR: 7.06, 95%CI: 5.78-8.63, P < 0.001; post-acute: IRR: 1.24, 95%CI: 1.14-1.36, P < 0.001) and adverse hepatic outcomes (acute: IRR: 1.98, 95%CI: 1.79-2.18, P < 0.001; post-acute: IRR: 1.24, 95%CI: 1.13-1.35, P < 0.001), compared to COVID-19-CLD. CONCLUSION Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC, they were more likely to receive palliative treatment than those without. The detrimental effects of SARS-CoV-2 infection persisted in post-acute phase. | - |
dc.language | eng | - |
dc.publisher | Baishideng Publishing Group | - |
dc.relation.ispartof | World Journal of Hepatology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Chronic liver disease | - |
dc.subject | Cirrhosis | - |
dc.subject | Hepatocellular carcinoma | - |
dc.subject | Long COVID | - |
dc.subject | Post-COVID-19 syndrome | - |
dc.subject | SARS-CoV-2 infection | - |
dc.title | Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease | - |
dc.type | Article | - |
dc.identifier.doi | 10.4254/wjh.v16.i2.211 | - |
dc.identifier.scopus | eid_2-s2.0-85188710525 | - |
dc.identifier.volume | 16 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 211 | - |
dc.identifier.epage | 228 | - |
dc.identifier.eissn | 1948-5182 | - |
dc.identifier.issnl | 1948-5182 | - |