Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study

Elizabeth S. Aby, Ghady Moafa, Nyan Latt, Mohammad T. Sultan, Paula A. Cacioppo, Sonal Kumar, Raymond T. Chung, Patricia P. Bloom, Jenna Gustafson, Michael Daidone, Zoe Reinus, Jose D. Debes, Sunny Sandhu, Aalam Sohal, Sameeha Khalid, Marina Roytman, Andreea Maria Catana, Kara Wegermann, Rotonya M. Carr, Yedidya SaimanIhab Kassab, Vincent L. Chen, Atoosa Rabiee, Carly Rosenberg, Veronica Nguyen, Christina Gainey, Kali Zhou, Kenneth Chavin, Blanca C. Lizaola-Mayo, David M. Chascsa, Lee Varelas, Akshata Moghe, Renumathy Dhanasekaran

Research output: Contribution to journalArticlepeer-review


Background: COVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited. Methods: We conducted a multicenter, observational cohort study of adult patients with CLD who were diagnosed with COVID-19 before May 30, 2020, to determine long-term clinical outcomes. We used a control group of patients with CLD confirmed negative for COVID-19. Results: We followed 666 patients with CLD (median age 58 years, 52.8% male) for a median of 384 (interquartile range: 31-462) days. The long-term mortality was 8.1%; with 3.6% experiencing delayed COVID-19-related mortality. Compared to a propensity-matched control group of patients with CLD without COVID-19 (n=1332), patients with CLD with COVID-19 had worse long-term survival [p<0.001; hazards ratio (HR): 1.69; 95% CI: 1.19-2.41] and higher rate of hospitalization (p<0.001, HR: 2.00, 1.62-2.48) over a 1-year follow-up period. Overall, 29.9% of patients reported symptoms of long-COVID-19. On multivariable analysis, female sex (p=0.05, HR: 2.45, 1.01-2.11), Hispanic ethnicity (p=0.003, HR: 1.94, 1.26-2.99), and severe COVID-19 requiring mechanical ventilation (p=0.028, HR: 1.74, 1.06-2.86) predicted long-COVID-19. In survivors, liver-related laboratory parameters showed significant improvement after COVID-19 resolution. COVID-19 vaccine status was available for 72% (n=470) of patients with CLD and history of COVID-19, of whom, 70% (n=326) had received the COVID-19 vaccine. Conclusions: Our large, longitudinal, multicenter study demonstrates a high burden of long-term mortality and morbidity in patients with CLD and COVID-19. Symptoms consistent with long-COVID-19 were present in 30% of patients with CLD. These results illustrate the prolonged implications of COVID-19 both for recovering patients and for health care systems.

Original languageEnglish (US)
Article numbere8874
JournalHepatology Communications
Issue number1
StatePublished - Jan 2023
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology


Dive into the research topics of 'Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study'. Together they form a unique fingerprint.

Cite this