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COVID-19 in patients with cirrhosis: understanding adverse impact
  1. Sanchit Sharma1,
  2. Anshuman Elhence1,
  3. Manas Vaishnav1,
  4. Ramesh Kumar2,
  5. Shalimar1
  1. 1 Gastroenterology and Human Nutrition, AIIMS, New Delhi, India
  2. 2 Gastroenterology, AIIMS Patna, Patna, India
  1. Correspondence to Dr Shalimar, Gastroenterology and Human Nutrition, AIIMS, New Delhi, 110029, Delhi, India; drshalimar{at}

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We read with great interest the article by Bajaj et al 1 comparing the outcomes of hospitalised patients with COVID-19+cirrhosis with that of patients with cirrhosis alone and COVID-19 alone. The authors found that the risk of mortality in patients with COVID-19+cirrhosis was not significantly higher than in patients with cirrhosis alone, though it was higher than patients with COVID-19 alone. The findings of the current study add to the existing understanding of the effects of COVID-19 in patients with cirrhosis;2–5 however, interpretation of such results must be mindful of two facts: first, the study subjects were not properly matched with regard to the severity of cirrhosis; and second, small and unbalanced sample size comparisons may lead to erroneous conclusions.

Model for end-stage liver disease (MELD) score is a reliable marker of severity of liver disease and predictor of mortality in patients with cirrhosis. In this study, patients with COVID-19+cirrhosis had …

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  • RK and S contributed equally.

  • Contributors SS: Writing of draft. AE: Revision of draft. MV: Revision of draft. RK: Writing of draft, critical revision and intellectual input. Shalimar: Writing of draft, critical revision and intellectual input.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.