COVID-19 in patients with preexisting liver disease: Clinical features and outcomes from northern Iran

Authors

  • Soroush Adiban Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
  • Tofigh Yaghubi Kalurazi Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
  • Mohammad Shenagari Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Pirooz Samidoust Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran https://orcid.org/0000-0002-7916-0677

DOI:

https://doi.org/10.61882/jcbior.6.2.316

Keywords:

Liver failure, Risk factor, Outcome, SARS-CoV-2 infection

Abstract

People living with chronic liver disease (CLD) may experience more severe consequences when infected with coronavirus disease 2019 (COVID-19). However, information from Middle Eastern populations is still limited. The present research examined the presentation and outcomes of COVID-19 among patients with underlying liver disorders in Northern Iran. To achieve this, a retrospective cross-sectional review was carried out in a major referral hospital between March 2020 and March 2023. Adult patients with confirmed COVID-19 and documented preexisting liver disease were included. Demographic, clinical, and outcome data were extracted and analyzed. Among 83 identified patients, common symptoms were myalgia (59%), cough (56.6%), and respiratory distress (49.4%). Hypoxemia (25.3%) was significantly associated with mortality (47.4% vs. 18.8%, P = 0.017). Altered consciousness also predicted poor outcomes (31.6% vs. 9.4%, P = 0.016). COVID-19 patients with preexisting liver disease had increased risk of adverse outcomes, with hypoxemia and altered mental status serving as key mortality predictors. Early recognition and tailored management are essential for this vulnerable group.

References

1. Kandi V, Thungaturthi S, Vadakedath S, Gundu R, Mohapatra RK. Mortality Rates of Coronavirus Disease 2019 (COVID-19) Caused by the Novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Cureus. 2021;13(3):e14081. DOI: 10.7759/cureus.14081 PMID: 33903841

2. Rasool G, Khan WA, Khan AM, Riaz M, Abbas M, Rehman AU, et al. COVID-19: A threat to the respiratory system. Int J Immunopathol Pharmacol. 2024;38:3946320241310307.

DOI: 10.1177/03946320241310307 PMID: 39716038

3. Jain U. Effect of COVID-19 on the Organs. Cureus. 2020;12(8):e9540. DOI: 10.7759/cureus.9540 PMID: 32905500

4. Feng G, Zheng KI, Yan QQ, Rios RS, Targher G, Byrne CD, et al. COVID-19 and Liver Dysfunction: Current Insights and Emergent Therapeutic Strategies. J Clin Transl Hepatol. 2020;8(1):18-24. DOI: 10.14218/JCTH.2020.00018

PMID: 32274342

5. Sahin TT, Akbulut S, Yilmaz S. COVID-19 pandemic: Its impact on liver disease and liver transplantation. World J Gastroenterol. 2020;26(22):2987-2999. DOI: 10.3748/wjg.v26.i22.2987

PMID: 32587443

6. Morales-Galicia AE, Ramírez-Mejía MM, Ponciano-Rodriguez G, Méndez-Sánchez N. Revolutionizing the understanding of liver disease: Metabolism, function and future. World J Hepatol. 2024;16(12):1365-1370. DOI: 10.4254/wjh.v16.i12.1365

PMID: 39744204

7. Zhu Q, Su C, Li M, Xu Y, Liu Q, Zhang Y, et al. Impact of Metabolic Dysfunction-Associated Fatty Liver Disease of Varying Severity on Antiviral Treatment Outcomes and Clinical Prognosis in Patients with Chronic Hepatitis B: A Systematic Review and Meta-analysis. Infect Dis Ther. 2025;14(8):1599-1617. DOI: 10.1007/s40121-025-01189-0 PMID: 40638020

8. Reznicek E, Sasaki K, Montane B, Sims A, Beard J, Fares M, et al. Outcomes of Liver Transplantation in Patients With Preexisting Coronary Artery Disease. Transplantation. 2023;107(4):933-940. DOI: 10.1097/TP.0000000000004402 PMID: 36397734

9. Huang SC, Su TH, Tseng TC, Liao SH, Hsu SJ, Hong CM, et al. Pre-Existing and New-Onset Metabolic Dysfunctions Increase Cirrhosis and Its Complication Risks in Chronic Hepatitis B. Am J Gastroenterol. 2025;120(2):401-409.

DOI: 10.14309/ajg.0000000000002915 PMID: 38920306

10. Hoferica J, Borbély RZ, Aghdam AN, Szalai EÁ, Zolcsák Á, Veres DS, et al. Chronic liver disease is an important risk factor for worse outcomes in acute pancreatitis: a systematic review and meta-analysis. Sci Rep. 2024;14(1):16723.

DOI: 10.1038/s41598-024-66710-w PMID: 39030187

11. Papagiouvanni I, Kotoulas SC, Pataka A, Spyratos DG, Porpodis K, Boutou AK, et al. COVID-19 and liver injury: An ongoing challenge. World J Gastroenterol. 2023;29(2):257-271.

DOI: 10.3748/wjg.v29.i2.257 PMID: 36687117

12. Hashemi N, Viveiros K, Redd WD, Zhou JC, McCarty TR, Bazarbashi AN, et al. Impact of chronic liver disease on outcomes of hospitalized patients with COVID-19: A multicentre United States experience. Liver Int. 2020;40(10):2515-2521.

DOI: 10.1111/liv.14583 PMID: 32585065

13. Afraie M, Mohammadzedeh P, Azami M, Khateri S, Zamani K, Moradpour F, et al. The association of chronic liver disorders with exacerbation of symptoms and complications related to COVID-19: A systematic review and meta-analysis of cohort studies. Clin Respir J. 2022;16(12):777-792. DOI: 10.1111/crj.13552

PMID: 36254683

14. Nagarajan R, Krishnamoorthy Y, Rajaa S, Hariharan VS. COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis. Prev Chronic Dis. 2022;19:E53. DOI: 10.5888/pcd19.210228

PMID: 36007255

15. Singh S, Khan A. Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease in the United States: A Multicenter Research Network Study. Gastroenterology. 2020;159(2):768-771.e3. DOI: 10.1053/j.gastro.2020.04.064 PMID: 32376408

16. Marjot T, Moon AM, Cook JA, Abd-Elsalam S, Aloman C, Armstrong MJ, et al. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study. J Hepatol. 2021;74(3):567-577.

DOI: 10.1016/j.jhep.2020.09.024 PMID: 33035628

17. Menezes LSM, da Cunha PFS, Pires MC, Valle LR, Costa FCC, Ferreira MAP, et al. Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort. BMC Infect Dis. 2025;25(1):68. DOI: 10.1186/s12879-024-10424-x PMID: 39815185

18. Hussaini H, Mohammed Abdul RH, Rauf MQ, Fahim R, Fadeyi O, Chaudhari SS, et al. The Impact of Liver Cirrhosis on Clinical Outcomes in Patients With Acute Pancreatitis: A Systematic Review and Meta-Analysis. Cureus. 2025;17(5):e84567.

DOI: 10.7759/cureus.84567 PMID: 40546612

19. Nusrat S, Khan MS, Fazili J, Madhoun MF. Cirrhosis and its complications: evidence based treatment. World J Gastroenterol. 2014;20(18):5442-60. DOI: 10.3748/wjg.v20.i18.5442

PMID: 24833875

20. Kim D, Adeniji N, Latt N, Kumar S, Bloom PP, Aby ES, et al. Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease: US Multi-center Study. Clin Gastroenterol Hepatol. 2021;19(7):1469-1479.e19.

DOI: 10.1016/j.cgh.2020.09.027 PMID: 32950749

Published

2025-06-30

Issue

Section

Brief reports

How to Cite

COVID-19 in patients with preexisting liver disease: Clinical features and outcomes from northern Iran. (2025). Journal of Current Biomedical Reports, 6(2), 41-44. https://doi.org/10.61882/jcbior.6.2.316

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