Ki Jung Lee, MD, Parth Patel, MD, Raffi Karagozian, MD Tufts Medicine, Boston, MA
Introduction: Patients with liver cirrhosis (LC) are at an increased risk of adverse outcomes associated with Coronavirus disease 2019 (COVID-19). Existing studies have demonstrated a higher prevalence of malnutrition among COVID-19 patients. However, there is limited research assessing the impact of malnutrition on COVID-19 patients hospitalized with cirrhosis.
Methods: We conducted a retrospective analysis of patients with LC admitted to hospitals in the United States (US) during 2020 using the National Inpatient Sample (NIS) database. We compared in-hospital mortality, the risk for acute kidney injury (AKI), and length of stay (LOS) between malnourished and non-malnourished LC patients with COVID-19. Multivariable logistic regression analysis was performed to assess the independent association between malnutrition in these patients and the outcomes of interest.
Results: Among 5,192 LC patients with COVID-19 and LC identified in the NIS database, 4,593 were not malnourished and 599 were malnourished. The median age of non-malnourished patients was 63 (interquartile range [IQR]: 54-72) and malnourished was 64 (IQR: 56-72). Examining the baseline characteristics, the following did not have statistically significant differences: sex (male: non-malnourished: 60.4% vs malnourished: 61.6%) and race (White: 50.5 vs 49.9%). Malnourished patients with LC and COVID-19 were more likely to have hyponatremia (36.2% vs. 26.1%) and chronic kidney disease (CKD) (24.4% vs. 20.2%) but less likely to have hypertension (24.9% vs. 32.3%), hyperlipidemia (23.5% vs. 31.3%), obesity (12.5% vs. 22.0%), and diabetes (8.8% vs. 15.6%). Malnourished patients had a significantly higher in-hospital mortality rate (28.5%) compared to non-malnourished patients (18.2%, p < 0.001). Malnutrition in LC and COVID-19 patients was associated with increased risk of in-hospital mortality (aOR 1.36, 95%CI 1.09-1.69, p < 0.01), AKI (aOR 5.58, 95%CI 4.71-6.61, p < 0.01), and LOS (unstandardized coefficient 5.29, 95%CI 4.52-6.06, p < 0.01).
Discussion: Malnutrition in hospitalized LC patients with COVID-19 is associated with a higher risk of in-hospital mortality, AKI, and LOS. These findings highlight the importance of multidisciplinary management to address nutritional status in COVID-19 patients with LC.
Figure: Figure 1. Forest plot of adjusted odd ratios of socioeconomic and demographics in the malnourished and non-malnourished patients with COVID-19 and Liver Cirrhosis.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ki Jung Lee indicated no relevant financial relationships.
Parth Patel indicated no relevant financial relationships.
Raffi Karagozian indicated no relevant financial relationships.
Ki Jung Lee, MD, Parth Patel, MD, Raffi Karagozian, MD. P1138 - Retrospective Analysis of the Impact of Malnutrition on Patients Hospitalized With Liver Cirrhosis and Covid-19 Infection, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
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