RISK FACTORS FOR SARS-COV-2 INFECTION AMONG PATIENTS WITH CHRONIC VIRAL HEPATITIS
Recommended Citation
Gordon SC, Rupp LB, Boscarino JA, Daida Y, Schmidt MA, Zhou YR, Trudeau S, Li J, and Lu M. RISK FACTORS FOR SARS-COV-2 INFECTION AMONG PATIENTS WITH CHRONIC VIRAL HEPATITIS. Hepatology 2020; 72:299A-300A.
Document Type
Conference Proceeding
Publication Date
11-2020
Publication Title
Hepatology
Abstract
Background: We investigated factors associated with risk of SARS-CoV-2 infection among an established cohort of chronic hepatitis B and C (CHB/ CHC) patients at a large, vertically integrated health system located in southeastern Michigan (which includes Detroit), a racially-diverse area that experienced a significant outbreak of COVID-19 during March–May 2020.
Methods: Patient characteristics and clinical conditions were collected for the period prior to date of first positive SARS-CoV-2 test, or March 11, 2020 for those who were not SARS-CoV-2 infected. Variables included: age; gender; race; insurance type; household income; BMI; CHC vs. CHB; AST; ALT; liver fibrosis status (as measured by APRI/ FIB4); diagnosis of liver cirrhosis; Charlson-Deyo comorbidity index; select individual comorbidities; and history of antiviral therapy. Patients coinfected with both CHB and CHC were excluded. Logistic regression, univariate followed by multivariable modeling, was performed. Variables with p-values <0.05 were retained in the final model.
Results: A total of 13,556 patients with a history of chronic viral hepatitis were included; 94 had a positive SARS-CoV-2 result. In univariate comparisons, there was a significant difference between groups (p<0.05) with regard to type of hepatitis infection (C vs. B), age, race, BMI, insurance type, household income, comorbidity index, AST, ALT, APRI, presence of cirrhosis, type 2 diabetes, chronic heart disease, renal disease, peripheral vascular disease, history of receipt of antiviral therapy, and achievement of sustained viral response (CHC). In the final multivariable model, increased risk of SARS-CoV-2 infection was associated with CHC vs CHB (adjusted Odds Ratio [aOR])=4.00, 95% confidence interval [CI] 1.89–8.47), presence of cirrhosis (aOR=1.66, 95%CI 1.08–2.55), normal AST at baseline (aOR=2.50, 95%CI 1.46–4.27), higher comorbidity index (aOR=1.40, 95%CI 1.19–1.67), Black/ African American vs white race (aOR=18.0, CI 6.59–45.5), and BMI (BMI 25–30 vs <25: aOR=3.82, CI 1.95–7.49; BMI >30 vs <25: aOR=2.85, CI 1.46–5.56).
Conclusion: In a cohort of chronic viral hepatitis patients drawn from a geographic area that experienced a significant COVID-19 outbreak, Black/ African American race, BMI>25, cirrhosis, CHC (active or post-SVR) vs. CHB, and higher comorbidity index were associated with higher risk of SARS-CoV-2 infection.
Volume
2020
Issue
72
First Page
299A
Last Page
300A