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Letter
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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    Footnotes

    • Collaborators CirCoV study group: M Iavarone, R D’Ambrosio, A Rimondi, P Lampertico (Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC “A. M. and A. Migliavacca” Center for Liver Disease, Milan, Italy); A Soria, P Bonfanti (Division of Infectious Diseases, San Gerardo Hospital, ASST Monza, University of Milan – Bicocca School of Medicine, Monza, Italy); M Triolo, S Fagiuoli (Gastroenterology 1 – Hepatology & Transplantology, ASST Papa Giovanni XXIII, Bergamo, Italy); N Pugliese, A Aghemo (Division of Internal Medicine and Hepatology, Department of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano (MI), Italy); P Del Poggio (Division of Gastroenterology, Policlinico S. Marco, Zingonia, Bergamo, Italy); G Perricone, L S Belli (Hepatology and Gastroenterology Unit, Niguarda Hospital, Milan, Italy); S Massironi, M Lucà, P Invernizzi (Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy); A Spinetti, C Carriero (Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili General Hospital, Brescia, Italy); E Buscarini, M. Pedaci (Division of Gastroenterology and Endoscopy, ASST Maggiore Hospital, Crema, Italy); M Viganò, M G Rumi (Division of Hepatology, San Giuseppe Hospital, Italy).

    • Contributors MI and PL designed the study and carried out the statistical analysis. MI and RD’A wrote the paper, and PL supervised and critically revised the paper. The data were collected by all the members of the CirCoV study group.

    • 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 MI: speaking/teaching, consultant and advisory board for Bayer, Gilead Sciences, BMS, Janssen, Ipsen, MSD, BTG-Boston Scientific, AbbVie, Guerbet, EISAI. RD’A: teaching and speaking for AbbVie, Gilead, MSD; Advisory Board for AbbVie, MSD, Research Grant from Gilead. PL: advisory board/speaker bureau for BMS, Roche, Gilead, GSK, AbbVie, MSD, Arrowhead, Alnylam, Janssen, Spring Bank, MYR, Eiger.

    • 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; externally peer reviewed.