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Combination of CLIF-OF and CCI predicts survival in patients with cirrhosis and COVID-19
  1. Massimo Iavarone1,
  2. Roberta D'Ambrosio1,
  3. Pietro Lampertico1,2
  1. 1 Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC “A. M. and A. Migliavacca” Center for Liver Disease, Milan, Italy
  2. 2 Department of Pathophysiology and Transplantation, University of Milan, Milano, Lombardia, Italy
  1. Correspondence to Dr Massimo Iavarone, Division of Gastroenterology and Hepatology, La Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milano 20122, Italy; massimo.iavarone{at}gmail.com

https://doi.org/10.1136/gutjnl-2020-322929

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    We read with interest the paper by Bajaj et al recently published on Gut, reporting high mortality rates in cirrhotic patients with COVID-19, as we previously showed in 50 cirrhotics enrolled in our study.1 2

    Although both studies reported an increased risk of mortality following SARS-CoV-2 infection in cirrhotics, as recently confirmed by other studies in both cirrhotic and liver transplanted patients, they differ for some aspects.1–4 Bajaj and colleagues enrolled younger patients (61.0±10.6 vs 67.6±10.1 years old), mostly women (73% vs 30%), and they found similar survival in cirrhotic patients with and without COVID-19, in contrast with what we previously reported.1 2 In the North American cohort, the Charlson Comorbidity Index (CCI) was independently associated with mortality (OR 1.23, 95% CI 1.11 to 1.37, p<0.0001),1 while in our cohort CLIF-OF (OR 1.77, 95% CI 1.24 to 2.54, p=0.002) and moderate to severe lung failure (OR 1.86, 95% 1.00–3.44, p=0.048) independently predicted mortality according to a logistic regression model.5 In the …

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