A real-world experience of SARS-CoV-2 infection in a tertiary referral centre of Montréal: Unexpected low prevalence and low mortality.

Canadian liver journal Pub Date : 2021-11-11 eCollection Date: 2021-01-01 DOI:10.3138/canlivj-2021-0022
Isaac Ruiz, Geneviève Huard, Claire Fournier, Julien Bissonnette, Hélène Castel, Jeanne-Marie Giard, Jean-Pierre Villeneuve, Daphna Fenyves, Denis Marleau, Bernard Willems, Daniel Corsilli, Florence Correal, Victor Ferreira, Dominic Martel, Alexandre Mathieu, Catherine Vincent, Marc Bilodeau
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Abstract

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with chronic liver disease (CLD) and liver transplant (LT) recipients remains a concern. The aim of this study was to report the impact of coronavirus disease 2019 (COVID-19) infection among patients at the tertiary health care centre Centre hospitalier de l'Université de Montréal (CHUM) during the first wave of the SARS-CoV-2 pandemic.

Methods: This real-world, retrospective cohort included all patients admitted to our liver unit and/or seen as an outpatient with CLD with or without cirrhosis and/or LT recipients who tested positive to SARS-CoV-2 infection. Cases were considered positive as defined by the detection of SARS-CoV-2 by reverse-transcription polymerase chain reaction (RT-PCR) on nasopharyngeal swabs.

Results: Between April 1 and July 31, 2020, 5,637 were admitted to our liver unit and/or seen as outpatient. Among them, 42 were positive for SARS-CoV-2. Twenty-two patients had CLD without cirrhosis while 16 patients had cirrhosis at the time of the infection (13, 2, and 1 with Child-Pugh A, B, and C scores, respectively). Four were LT recipients. Overall, 15 of 42 patients (35.7%) were hospitalized; among them, 7 of 42 (16.7%) required respiratory support and 4 of 42 (9.5%) were transferred to the intensive care unit. Only 4 of 42 (9.5%) patients died: 2 with CLD without cirrhosis and 2 with CLD with cirrhosis. Overall survival was 90.5%.

Conclusion: This real-world study demonstrates an unexpectedly low prevalence and low mortality in the context of SARS-CoV-2 infection among patients with CLD with or without cirrhosis and LT recipients.

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蒙特里萨伊三级转诊中心SARS-CoV-2感染的真实经验:意外的低患病率和低死亡率。
背景:严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染对慢性肝病(CLD)患者和肝移植(LT)受者的影响仍是一个值得关注的问题。本研究的目的是报告在第一波SARS-CoV-2大流行期间,2019年冠状病毒病(COVID-19)感染对三级医疗保健中心蒙特里萨大学中心(CHUM)患者的影响。方法:这一现实世界的回顾性队列包括所有在我们的肝脏部门住院和/或门诊就诊的CLD患者,伴有或不伴有肝硬化和/或肝移植患者,这些患者的SARS-CoV-2感染检测呈阳性。鼻咽拭子逆转录聚合酶链反应(RT-PCR)检测SARS-CoV-2为阳性。结果:在2020年4月1日至7月31日期间,有5637人入住我们的肝脏部门和/或作为门诊就诊。其中新冠病毒阳性42例。22例CLD患者无肝硬化,16例患者感染时有肝硬化(分别有13例、2例和1例Child-Pugh评分为A、B和C)。4例为肝移植受体。总体而言,42例患者中有15例(35.7%)住院;42例患者中有7例(16.7%)需要呼吸支持,4例(9.5%)转入重症监护病房。42例患者中仅有4例(9.5%)死亡:2例CLD无肝硬化,2例CLD合并肝硬化。总生存率为90.5%。结论:这项现实世界的研究表明,在伴有或不伴有肝硬化和肝移植的CLD患者中,SARS-CoV-2感染的发生率和死亡率出乎意料地低。
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