Copyright
©The Author(s) 2021.
World J Clin Cases. Oct 16, 2021; 9(29): 8749-8762
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8749
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8749
Table 1 Comparison between patients with and without hepatitis C virus, n (%)
All patients (n = 1193) | Propensity score matched1 (n = 98) | |||||
No HCV (n = 1143) | HCV (n = 50) | P value | No HCV (n = 48) | HCV (n = 50) | P value | |
Age (yr) | 62 ± 16 | 64 ± 9 | 0.402 | 64 ± 15 | 64 ± 9 | 0.803 |
Gender (female) | 456 (39.90) | 14 (28.00) | 0.092 | 20 (41.67) | 14 (28.00) | 0.155 |
Body mass index (kg/m2) | 30 ± 7 | 27.7 ± 8.5 | 0.026 | 27.9 ± 6.8 | 28 ± 9 | 0.917 |
Hypertension | 703 (61.50) | 31 (62.00) | 0.944 | 33 (68.75) | 31 (62.00) | 0.483 |
Diabetes mellitus) | 530 (46.37) | 17 (34.00) | 0.086 | 17 (35.42) | 17 (34.00) | 0.883 |
Human immune-deficiency virus | 58 (05.07) | 21 (42.00) | < 0.001 | 17 (35.42) | 21 (42.00) | 0.504 |
Asthma | 144 (12.60) | 10 (20.00) | < 0.001 | 9 (18.75) | 10 (20.00) | 0.612 |
Chronic obstructive pulmonary disease | 105 (09.19) | 14 (28.00) | < 0.001 | 9 (18.75) | 14 (28.00) | 0.280 |
Hepatitis B infection | 1 (00.09) | 3 (06.00) | < 0.001 | 0 (00.00) | 3 (06.00) | 0.085 |
Congestive heart failure | 105 (09.19) | 12 (24.00) | 0.001 | 10 (20.83) | 12 (24.00) | 0.707 |
Coronary artery disease | 119 (10.41) | 6 (12.00) | 0.720 | 6 (12.50) | 6 (12.00) | 0.940 |
Chronic kidney disease | 89 (07.79) | 9 (18.00) | 0.01 | 5 (10.42) | 9 (18.00) | 0.284 |
End stage renal disease | 77 (06.74) | 5 (10.00) | 0.372 | 2 (04.17) | 5 (10.00) | 0.262 |
Fever | 753 (65.88) | 31 (62.00) | 0.525 | 26 (54.17) | 31 (62.00) | 0.585 |
Cough | 771 (67.45) | 24 (48.00) | 0.003 | 27 (56.25) | 24 (48.00) | 0.294 |
Shortness of breath | 787 (68.85) | 40 (80.00) | 0.110 | 34 (70.83) | 40 (80.00) | 0.478 |
Myalgia | 352 (30.80) | 11 (22.00) | 0.175 | 19 (39.58) | 11 (22.00) | 0.04 |
Chest discomfort | 144 (12.60) | 5 (10.00) | 0.572 | 3 (06.25) | 5 (10.00) | 0.538 |
Atypical symptoms | 392 (34.30) | 19 (38.00) | 0.611 | 20 (41.67) | 19 (38.00) | 0.585 |
Symptom onset to hospitalization (d) | 5.85 ± 5.56 | 3.79 ± 4.04 | 0.034 | 6.2 ± 5.7 | 3.8 ± 4.04 | 0.053 |
Length of hospital stay (d) | 8.05 ± 7.05 | 6.2 ± 4.3 | 0.072 | 7 ± 5.79802 | 6.2 ± 4.3 | 0.454 |
Hemoglobin | 13.0 ± 2.2 | 12.2 ± 2.7 | 0.021 | 12.5 ± 2.1 | 12.2 ± 2.7 | 0.598 |
Total white count | 8.6 ± 6.6 | 9.8 ± 13.1 | 0.244 | 7.78 ± 3.5 | 9.8 ± 13.1 | 0.300 |
Platelets | 221.7 ± 103.3 | 183 ± 73.5 | 0.015 | 234.4 ± 100 | 183 ± 73 | 0.007 |
Neutrophilic count | 6.8 ± 4.05 | 6.1 ± 3.8 | 0.224 | 6.3 ± 3.4 | 6.1 ± 3.8 | 0.780 |
Lymphocyte count | 1.18 ± 4.86 | 2.86 ± 12.3 | 0.037 | 0.99 ± 0.52 | 2.86 ± 12.3 | 0.302 |
D-dimer | 3115 ± 9997 | 2270 ± 5383 | 0.582 | 6883 ± 28017 | 2270 ± 5383 | 0.293 |
Lactate dehydrogenase | 581 ± 393 | 623 ± 391 | 0.477 | 523 ± 419 | 623 ± 391 | 0.248 |
High sensitivity C-reactive protein | 143 ± 113 | 98 ± 76 | 0.013 | 129 ± 89 | 98 ± 75 | 0.095 |
Ferritin | 1148 ± 1574 | 1265 ± 2098 | 0.647 | 1053 ± 1267 | 1265 ± 2098 | 0.576 |
Lactate | 2.3 ± 1.9 | 2.7 ± 2.6 | 0.265 | 2.07 ± 1.3 | 2.7 ± 2.6 | 0.189 |
Prothrombin time (s) | 14 ± 10.7 | 13.4 ± 2.5 | 0.716 | 13.6 ± 2.3 | 13.4 ± 2.4 | 0.700 |
Activated partial thromboplastin time (s) | 32.2 ± 7.9 | 32.7 ± 6.3 | 0.67 | 31.4 ± 5.4 | 32.7 ± 6.3 | 0.317 |
Creatinine | 1.9 ± 2.6 | 3.3 ± 3.5 | < 0.001 | 2.01 ± 2.4 | 3.3 ± 3.5 | 0.039 |
Alanine transaminase | 43.7 ± 66.4 | 53.2 ± 121.7 | 0.386 | 40.8 ± 37.5 | 53.2 ± 121.7 | 0.538 |
Aspartate transaminase | 68.6 ± 90.8 | 128.1 ± 367.2 | 0.001 | 59.8 ± 43.5 | 128.2 ± 367 | 0.246 |
Alkalaine phosphatase | 94.2 ± 86.4 | 111.5 ± 143 | 0.224 | 82.3 ± 40.7 | 111.5 ± 143 | 0.217 |
Total bilirubin | 0.6 ± 0.7 | 0.8 ± 0.86 | 0.111 | 0.54 ± 0.41 | 0.8 ± 0.9 | 0.087 |
Combined bilirubin | 0.27 ± 0.45 | 0.45 ± 0.68 | 0.02 | 0.26 ± 0.28 | 0.45 ± 0.68 | 0.115 |
Total protein | 6.98 ± 0.83 | 7.2 ± 0.98 | 0.163 | 6.91 ± 0.72 | 7.2 ± 0.98 | 0.175 |
Albumin | 3.59 ± 0.55 | 3.44 ± 0.56 | 0.089 | 3.6 ± 0.5 | 3.4 ± 0.6 | 0.209 |
Procalcitonin | 2.34 ± 9.4 | 7.27 ± 21.4 | 0.02 | 3.08 ± 8.8 | 7.3 ± 21.4 | 0.453 |
Hydroxychloroquine | 878 (76.82) | 36 (72.00) | 0.711 | 33 (68.75) | 36 (72.00) | 0.725 |
Azithromycin | 839 (73.40) | 32 (64.00) | 0.303 | 35 (72.92) | 32 (64.00) | 0.343 |
Tocilizumab | 78 (06.82) | 0 (00.00) | 0.149 | 4 (08.33) | 0 (00.00) | 0.054 |
Mechanical ventilation | 449 (39.28) | 29 (58.00) | 0.003 | 4 (08.33) | 29 (58.00) | < 0.001 |
Death | 386 (33.77) | 28 (56.00) | 0.004 | 7 (14.58) | 28 (56.00) | < 0.001 |
Table 2 Cox regression model for all patients and hepatitis C virus patients for prediction of mortality
All patients (n = 1193) | Propensity score matched (n = 98) | |||||||
Univariate | Multivariate | Univariate | Multivariate | |||||
Exp (B) | Sig. | Exp (B) | Sig. | Exp (B) | Sig. | Exp (B) | Sig. | |
Age (yr) | 1.028 | < 0.001 | 1.029 | < 0.001 | 1.022 | 0.183 | - | - |
Gender (female) | 0.675 | < 0.001 | 0.865 | 0.42 | 0.488 | 0.05 | 0.714 | 0.110 |
Body mass index (kg/m2) | 0.991 | 0.184 | - | - | 1.014 | 0.514 | - | - |
Hypertension | 1.611 | < 0.001 | 0.843 | 0.386 | 2.87 | 0.004 | 2 | 0.051 |
Diabetes mellitus | 1.394 | 0.001 | 1.208 | 0.277 | 1.06 | 0.864 | - | - |
Human immune-deficiency virus | 1.797 | < 0.001 | 1.251 | 0.492 | 1.92 | 0.064 | - | - |
Asthma | 0.864 | 0.341 | - | - | 1.39 | 0.357 | - | - |
Chronic obstructive pulmonary disease | 1.435 | 0.013 | 1.043 | 0.879 | 1.222 | 0.591 | - | - |
Hepatitis B infection | 1.984 | 0.237 | - | - | 1.04 | 0.962 | - | - |
HCV | 2.224 | < 0.001 | 2.435 | 0.041 | 3.88 | 0.001 | 3.46 | 0.004 |
Congestive heart failure | 1.4 | 0.02 | 1.249 | 0.356 | 1.253 | 0.545 | - | - |
Coronary artery disease | 1.387 | 0.023 | 1.092 | 0.734 | 1.05 | 0.923 | - | - |
End stage renal disease | 1.208 | 0.305 | - | - | 1.013 | 0.983 | - | - |
Chronic kidney disease | 1.437 | 0.016 | 1.188 | 0.535 | 1.024 | 0.957 | - | - |
Hemoglobin | 0.966 | 0.123 | - | - | 0.925 | 0.337 | - | - |
Total white count | 1.006 | 0.376 | - | - | 1.004 | 0.736 | - | - |
Platelets | 0.998 | < 0.001 | 0.999 | 0.438 | 0.999 | 0.525 | - | - |
Neutrophilic count | 1.023 | 0.028 | 0.991 | 0.658 | 1.072 | 0.145 | - | - |
Lymphocyte count | 0.993 | 0.641 | 1 | 0.163 | 1.000 | 0.976 | - | - |
D-dimer | 1 | < 0.001 | 1.001 | < 0.001 | 1.000 | 0.09 | - | - |
Lactate dehydrogenase | 1.001 | < 0.001 | 1.001 | 0.374 | 1.000 | 0.714 | - | - |
High sensitivity C-reactive protein | 1.002 | < 0.001 | 1 | 0.553 | 0.999 | 0.788 | - | - |
Ferritin | 1 | 0.002 | 1.053 | 0.028 | 1.000 | 0.902 | - | - |
Prothrombin time (s) | 1.001 | 0.89 | - | - | 1.1 | 0.281 | - | - |
Activated partial thromboplastin time (s) | 0.998 | 0.804 | - | - | 0.966 | 0.281 | - | - |
Creatinine | 1.072 | < 0.001 | - | - | 1.08 | 0.91 | - | - |
Alanine transaminase | 0.999 | 0.325 | - | - | 0.998 | 0.371 | - | - |
Aspartate transaminase | 1 | 0.391 | - | - | 0.999 | 0.402 | - | - |
Alkalaine phosphatase | 0.999 | 0.222 | - | - | 0.275 | 0.995 | - | - |
Total bilirubin | 1.131 | 0.002 | 1.026 | 0.925 | 1.16 | 0.475 | - | - |
Combined bilirubin | 1.327 | < 0.001 | 1.091 | 0.733 | 1.17 | 0.510 | - | - |
Total protein | 0.932 | 0.235 | - | - | 0.892 | 0.560 | - | - |
Albumin | 0.681 | < 0.001 | 0.933 | 0.678 | 0.613 | 0.114 | - | - |
Procalcitonin | 1.014 | < 0.001 | 1.001 | 0.793 | 1.008 | 0.544 | - | - |
Table 3 Comparison between liver enzymes, acute liver injury, chronic liver disease, and fibrosis score between patients with and without hepatitis C virus, n (%)
All (n = 1065) | ALI patients (n = 1065) | Propensity score matched (n = 81) | |||||
No HCV (n = 1014) | HCV (n = 41) | P value | No HCV (n = 40) | HCV (n = 41) | P value | ||
AST/ALT | 1.88 ± 1.5 | 1.86 ± 1.5 | 2.4 ± 1.3 | 0.023 | 1.8 ± 0.88 | 2.4 ± 1.27 | 0.015 |
Any liver enzyme elevated | 639 (60) | 610 (60) | 29 (71) | 0.174 | 25 (63) | 29 (71) | 0.423 |
Normal liver enzymes | 416 (39) | 311 (31) | 10 (24) | 0.242 | 15 (38) | 10 (24) | 0.223 |
Only ALT elevated | 6 (1) | 6 (1) | 0 (0) | 0 (0) | 0 (0) | ||
Only AST elevated | 432 (41) | 409 (40) | 23 (56) | 15 (38) | 2356 | ||
Both elevated | 201 (19) | 195 (19) | 6 (15) | 10 (25) | 6 (15) | ||
AST > ALT | 423 (40) | 399 (39) | 20 (49) | 0.394 | 0.394 | ||
All AST > ALT | 633 (59) | 604 (60) | 29 (71) | 0.153 | 25 (63) | 29 (71) | 0.423 |
Fatty liver | 50 (5) | 48 (5) | 2 (5) | 0.931 | 1 (3) | 2 (5) | 0.582 |
History of cirrhosis | 6 (1) | 5 (1) | 1 (2) | 0.228 | 2 (5) | 1 () | 0.534 |
Fib-4 score | 3.43 ± 5.5 | 3.47 ± 5.6 | 3.1 ± 3.6 | 0.642 | 3.4 ± 2.25 | 3.1 ± 3.6 | 0.249 |
ALI1 | 107 (10) | 100 (10) | 7 (17) | 0.128 | 3 (8) | 7 (17) | 0.166 |
Table 4 Comparison between Liver enzymes, acute liver injury, and fibrosis score between patients with and without hepatitis C virus for prediction of mortality, n (%)
ALl patients (n = 1065) | Propensity score matched (n = 81) | |||||||
Univariate | Multivariate | Univariate | Multivariate | |||||
Exp (B) | Sig. | Exp (B) | Exp (B) | Sig. | Exp (B) | Sig. | Sig. | |
AST/ALT | 1.1 | < 0.001 | 1.06 | < 0.001 | 1.204 | 0.221 | - | - |
Any liver enzyme elevated | 1.427 | 0.002 | 0.001 | 0.823 | 1.204 | 0.624 | - | - |
All AST > ALT | 1.455 | 0.001 | 0.001 | 0.852 | 1.204 | 0.624 | - | - |
History of cirrhosis | 1.368 | 0.659 | - | - | 1.95 | 0.513 | - | - |
ALI1 | 1.418 | 0.015 | 1.045 | 0.792 | 1.132 | 0.817 | - | - |
Fib-4 score | 1.02 | < 0.001 | 1.022 | < 0.001 | 1.1 | 0.042 | 1.1 | 0.08 |
HCV | 2.224 | < 0.001 | 2.15 | < 0.001 | 3.88 | 0.001 | 3.75 | 0.002 |
Table 5 Subgroup comparisons and cox-regression predictors of outcomes for a subset composed of patients with chronic hepatitis C virus and propensity score matched patients without hepatitis C virus, n (%)
Propensity score matched (n = 72) | |||||||
Comparison between groups | Cox-regression analysis | ||||||
Univariate | Multivariate | ||||||
NO HCV (n = 48) | HCV with viral load (n = 24) | P value | Exp (B) | Sig. | Exp (B) | Sig. | |
Age (yr) | 64.4 ± 15.1 | 64.4 ± 9.8 | 0.995 | 1.021 | 0.293 | - | - |
Gender (female) | 28 (58) | 17 (71) | 0.302 | 0.481 | 0.088 | - | - |
Body mass index (kg/m2) | 27.9 ± 6.8 | 26.0 ± 6.2 | 0.252 | 1.014 | 0.625 | - | - |
Hypertension | 33 (69) | 16 (67) | 0.858 | 3.03 | 0.014 | 2.55 | 0.035 |
Diabetes mellitus | 17 (35) | 7 (29) | 0.596 | 1.05 | 0.902 | - | - |
Human immune-deficiency virus | 17 (35) | 9 (38) | 0.862 | 1.79 | 0.185 | - | - |
Asthma | 9 (19) | 4 (17) | 0.828 | 1.81 | 0.251 | - | - |
Chronic obstructive pulmonary disease | 9 (19) | 5 (21) | 0.833 | 1.386 | 0.483 | - | - |
Hepatitis B infection | 1 (0.2) | 0 (0) | 0.476 | 1.04 | 0.976 | - | - |
HCV | 0 (0) | 24 (100) | - | 3.47 | 0.007 | 3.2 | 0.014 |
Congestive heart failure | 10 (21) | 5 (21) | 1.000 | 1.41 | 0.448 | - | - |
Coronary artery disease | 6 (13) | 2 (8) | 0.596 | 1.12 | 0.845 | - | - |
End stage renal disease | 2 (0.4) | 1 (4) | 1.000 | 1.65 | 0.628 | - | - |
Chronic kidney disease | 5 (10) | 6 (25) | 0.105 | 1.1 | 0.875 | - | - |
Hemoglobin | 12.5 ± 2.1 | 11.7 ± 2.6 | 0.166 | 0.921 | 0.424 | - | - |
Total white count | 7.8 ± 3.5 | 12 ± 17.9 | 0.122 | 1.006 | 0.618 | - | - |
Platelets | 234.4 ± 100.3 | 185 ± 86.2 | 0.051 | 1.000 | 0.978 | - | - |
Neutrophilic count | 6.27 ± 3.4 | 6.24 ± 4.3 | 0.981 | 1.11 | 0.056 | - | - |
Lymphocyte count | 0.99 ± 0.5 | 4.62 ± 17.0 | 0.145 | 1.002 | 0.897 | - | - |
D-dimer | 6883 ± 28017 | 1154 ± 1807 | 0.333 | 1.000 | 0.054 | - | - |
Lactate dehydrogenase | 523 ± 419 | 649 ± 484 | 0.273 | 1.000 | 0.898 | - | - |
High sensitivity C-reactive protein | 129 ± 90 | 113 ± 89 | 0.518 | 0.999 | 0.751 | - | - |
Ferritin | 1053 ± 1267 | 1373 ± 2775 | 0.533 | 1.000 | 0.661 | - | - |
Prothrombin time (s) | 13.6 ± 2.3 | 13.5 ± 2.5 | 0.820 | 1.05 | 0.636 | - | - |
Activated partial thromboplastin time (s) | 31.4 ± 5.4 | 32.9 ± 7.28 | 0.365 | 0.935 | 0.138 | - | - |
Creatinine | 2.01 ± 2.4 | 3.2 ± 4. | 0.132 | 1.06 | 0.315 | - | - |
Alanine transaminase | 40.8 ± 37.5 | 62.1 ± 169.8 | 0.448 | 0.998 | 0.427 | - | - |
Aspartate transaminase | 59.8 ± 43.5 | 169.8 ± 518.6 | 0.185 | 0.999 | 0.433 | - | - |
Alkaline phosphatase | 82.3 ± 40.7 | 114.5 ± 165.7 | 0.246 | 0.996 | 0.376 | - | - |
Total bilirubin | 0.54 ± 0.4 | 0.93 ± 1.1 | 0.05 | 1.236 | 0.336 | - | - |
Combined bilirubin | 0.26 ± 0.28 | 0.58 ± 0.9 | 0.05 | 1.223 | 0.428 | - | - |
Total protein | 6.91 ± 0.72 | 7.0 ± 0.95 | 0.618 | 0.813 | 0.380 | - | - |
Albumin | 3.6 ± 0.51 | 3.3 ± 0.52 | 0.073 | 0.509 | 0.079 | - | - |
Procalcitonin | 3.1 ± 8.8 | 4.6 ± 11.7 | 0.695 | 0.984 | 0.538 | - | - |
Hydroxychloroquine | 33 (69) | 18 (75) | 0.582 | - | - | - | - |
Azithromycin | 35 (73) | 13 (54) | 0.112 | - | - | - | - |
Tocilizumab | 4 (8) | 0 (0) | 0.146 | - | - | - | - |
Mechanical ventilation | 4 (8) | 15 (63) | < 0.001 | - | - | - | - |
Death | 7 (15) | 15 (63) | < 0.001 | - | - | - | - |
- Citation: Ronderos D, Omar AMS, Abbas H, Makker J, Baiomi A, Sun H, Mantri N, Choi Y, Fortuzi K, Shin D, Patel H, Chilimuri S. Chronic hepatitis-C infection in COVID-19 patients is associated with in-hospital mortality. World J Clin Cases 2021; 9(29): 8749-8762
- URL: https://www.wjgnet.com/2307-8960/full/v9/i29/8749.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v9.i29.8749