Mak, Lung Yi, Chung, Matthew Shing Hin, Li, Xue, Lai, Francisco Tsz Tsun, Wan, Eric Yuk Fai, Chui, Celine Sze Ling, Cheng, Franco Wing Tak, Chan, Esther Wai Yin, Cheung, Ching Lung, Au, Ivan Chi Ho, Xiong, Xi, Seto, Wai-Kay, Yuen, Man-Fung, Wong, Carlos King Ho and Wong, Ian Chi Kei (2024). Effects of SARS-CoV-2 infection on incidence and treatment strategies of hepatocellular carcinoma in people with chronic liver disease. World journal of hepatology, 16 (2), pp. 211-228.
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.
Publication DOI: | https://doi.org/10.4254/wjh.v16.i2.211 |
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Divisions: | College of Health & Life Sciences > Aston Pharmacy School |
Funding Information: | This work was supported by a research grant from Collaborative Research Fund, University Grants Committee, HKSAR Government (principal investigator, Wong ICK; reference no. C7154-20GF). Lai FTT, Wong CKH, and Wong ICK are partially supported by the Labora |
Additional Information: | Copyright © The Author(s) 2024. Published by Baishideng Publishing Group Inc. This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
Uncontrolled Keywords: | Chronic liver disease,Cirrhosis,Hepatocellular carcinoma,Long COVID,Post-COVID-19 syndrome,SARS-CoV-2 infection |
Publication ISSN: | 1948-5182 |
Data Access Statement: | The data that support the findings of this study were provided by the Hong Kong Hospital Authority. Restrictions apply to the availability of these data, which were used under license for this study. |
Last Modified: | 08 Aug 2024 07:08 |
Date Deposited: | 07 Aug 2024 17:01 |
Full Text Link: | |
Related URLs: |
https://www.wjg ... /v16/i2/211.htm
(Publisher URL) http://www.scop ... tnerID=8YFLogxK (Scopus URL) |
PURE Output Type: | Article |
Published Date: | 2024-02-27 |
Published Online Date: | 2024-02-27 |
Accepted Date: | 2024-01-30 |
Authors: |
Mak, Lung Yi
Chung, Matthew Shing Hin Li, Xue Lai, Francisco Tsz Tsun Wan, Eric Yuk Fai Chui, Celine Sze Ling Cheng, Franco Wing Tak Chan, Esther Wai Yin Cheung, Ching Lung Au, Ivan Chi Ho Xiong, Xi Seto, Wai-Kay Yuen, Man-Fung Wong, Carlos King Ho Wong, Ian Chi Kei ( ![]() |