Mortality Increased Among Hospitalized Patients with Cirrhosis Before and Following Different Waves of the COVID-19 Pandemic

Patrick A. Twohig, Kyle Scholten, Makayla Schissel, Kevin Brittan, Jason Barbaretta, Kaeli Samson, Lynette Smith, Mark Mailliard, Thoetchai Bee Peeraphatdit

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background: The Coronavirus disease 2019 (COVID-19) pandemic disrupted patient care and worsened the morbidity and mortality of some chronic diseases. The impact of the COVID-19 pandemic on hospitalizations and outcomes in patients with cirrhosis both before and during different time periods of the pandemic has not been evaluated. Aims: Describe characteristics of hospitalized patients with cirrhosis and evaluate inpatient mortality and 30-day readmission before and after the start of the COVID-19 pandemic. Methods: Retrospective single-center cohort study of all hospitalized patients with cirrhosis from 2018 to 2022. Time periods within the COVID-19 pandemic were defined using reference data from the World Health Organization and Centers for Disease Control. Adjusted odds ratios from logistic regression were used to assess differences between periods. Results: 33,926 unique hospitalizations were identified. Most patients were over age 60 years across all time periods of the pandemic. More Hispanic patients were hospitalized during COVID-19 than before COVID-19. Medicare and Medicaid are utilized less frequently during COVID-19 than before COVID-19. After controlling for age and gender, inpatient mortality was significantly higher during all COVID-19 periods except Omicron compared to before COVID-19. The odds of experiencing a 30-day readmission were 1.2 times higher in the pre-vaccination period compared to the pre-COVID-19 period. Conclusion: Inpatient mortality among patients with cirrhosis has increased during the COVID-19 pandemic compared to before COVID-19. Although COVID-19 infection may have had a small direct pathologic effect on the natural history of cirrhotic liver disease, it is more likely that other factors are impacting this population.

Original languageEnglish (US)
Pages (from-to)4381-4388
Number of pages8
JournalDigestive Diseases and Sciences
Issue number12
StatePublished - Dec 2023


  • COVID-19
  • Cirrhosis
  • Hospitalization
  • Mortality
  • Readmission

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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