People hospitalized with COVID-19 who also had hepatitis C and liver cirrhosis had a higher mortality rate than those without the liver disease, according to study findings were presented at The Liver Meeting 2023. But hepatitis C virus (HCV) in the absence of cirrhosis did not appear to be linked to a higher risk of death.

Over the course of the pandemic, research has yielded mixed results about clinical outcomes of COVID-19 in people with liver disease. More severe COVID has been linked to fatty liver disease and advanced cirrhosis, but the association with hepatitis C is not well understood.

Jose Debes, MD, PhD, of the University of Minnesota Medical School, and colleagues carried out a study to understand the effect of chronic HCV infection in people hospitalized with COVID during the first year of the pandemic in the United States, before vaccines were available.

Using the National Inpatient Sample database, the researchers retrospectively analyzed COVID hospitalizations in 2020. The researchers identified more than 1 million COVID hospitalizations. Just over half of hospitalized people (53%) were men, and the average age was about 65 years.

Among people hospitalized with COVID, 8,040 (0.8%) had a history of hepatitis C. Those with HCV were younger on average (62 years), were more likely to be male (68%) and Black and had a higher burden of comorbidities compared to people without HCV. Information about hepatitis treatment status was not available.

Debes and colleagues found that hepatitis C alone was not significantly associated with increased mortality while hospitalized with COVID. But people with HCV infection and cirrhosis did have a higher risk of death. What’s more, HCV infection alone was linked to longer hospital stays.

“While cirrhosis increases mortality in those hospitalized with COVID-19, HCV in the absence of cirrhosis does not appear to be a risk factor for COVID-19 related mortality,” the researchers concluded.

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