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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Virus and Host
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1471974

Clinical characteristics and the role of IL-6 in acute-on-chronic liver failure patients with or without COVID-19: A multicenter paired cohort study

Provisionally accepted
Ruoyu Yao Ruoyu Yao 1Wenrui Zhang Wenrui Zhang 1Xiujuan Fu Xiujuan Fu 1Guofen Xu Guofen Xu 1Han Wang Han Wang 1Yu Chen Yu Chen 2*Jia Yao Jia Yao 1*
  • 1 Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan, China
  • 2 Beijing Youan Hospital, Capital Medical University, Beijing, Shaanxi Province, China

The final, formatted version of the article will be published soon.

    Background and Aims The impact of coronavirus disease 2019 (COVID-19) on patients with acute-on-chronic liver failure (ACLF) remains unclear. To investigate the clinical characteristics of patients with ACLF complicated with COVID-19 in order to provide evidence for the precise treatment of this patient population. Methods A total of 34 ACLF patients with COVID-19 admitted to these three hospitals from December 2022 to August 2023 were included as the ACLF+COVID-19 group. Additionally, 34 age-, gender-, etiology-, and Model for End-Stage Liver Disease-Sodium (MELD-Na) score-matched ACLF patients were screened from 286 ACLF patients as the ACLF group. From 382 COVID-19 patients, 34 were selected as the COVID-19 group, matching the ACLF+COVID-19 group in age, gender, and illness severity. Clinical features of these three groups were compared, with the primary measure being the 28-day mortality rate in the ACLF patients and the secondary measures including clinical symptoms, laboratory tests, comorbidities, and complications in three groups. Results Compared with the ACLF group, the ACLF+COVID-19 group had significantly higher incidence rates of fever, cough, sputum production, fatigue, and hypoxemia (all p<0.01). Patients in the ACLF+COVID-19 group were more likely to have hepatic encephalopathy (p=0.015), lower platelet count (p=0.016) and elevated IL-6 level (p=0.026), and higher MELD-Na score (p=0.041) one week after admission, but without a significant increase in 28-day mortality rate (p=0.16). Conclusions ACLF patients with COVID-19 have increased risk for thrombocytopenia, more obvious inflammatory response, and rapid disease progression 1 week after admission, but the 28-day mortality rate is similar to that of ACLF patients without COVID-19.

    Keywords: Acute-on-chronic liver failure, COVID-19, SARS-CoV-2, Mortality, prognosis

    Received: 28 Jul 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Yao, Zhang, Fu, Xu, Wang, Chen and Yao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yu Chen, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, Shaanxi Province, China
    Jia Yao, Shanxi Bethune Hospital, Shanxi Medical University, Taiyuan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.