88 results on '"Avitabile, Emma"'
Search Results
2. Prospective validation of the EASL management algorithm for acute kidney injury in cirrhosis
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Ma, Ann Thu, Solé, Cristina, Juanola, Adrià, Escudé, Laia, Napoleone, Laura, Avitabile, Emma, Pérez-Guasch, Martina, Carol, Marta, Pompili, Enrico, Gratacós-Ginés, Jordi, Soria, Anna, Rubio, Ana Belén, Cervera, Marta, Moreta, Maria José, Morales-Ruiz, Manuel, Solà, Elsa, Poch, Esteban, Fabrellas, Núria, Graupera, Isabel, Pose, Elisa, and Ginès, Pere
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- 2024
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3. Alcoholic Foamy Degeneration, an Entity Resembling Alcohol-Associated Hepatitis: Diagnosis, Prognosis, and Molecular Profiling
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Gratacós-Ginès, Jordi, Avitabile, Emma, Montironi, Carla, Guillamon-Thiery, Alex, Hernández-Évole, Helena, Moreta, María José, Blaya, Delia, Ariño, Silvia, Rubio, Ana Belén, Pérez-Guasch, Martina, Cervera, Marta, Carol, Marta, Fabrellas, Núria, Soria, Anna, Juanola, Adrià, Graupera, Isabel, Sancho-Bru, Pau, Díaz, Alba, Coll, Mar, Bataller, Ramón, Ginès, Pere, and Pose, Elisa
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- 2024
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4. Immune responses and clinical outcomes after COVID-19 vaccination in patients with liver disease and liver transplant recipients
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Murray, Sam M., Pose, Elisa, Wittner, Melanie, Londoño, Maria-Carlota, Schaub, Golda, Cook, Jonathan, Dimitriadis, Stavros, Meacham, Georgina, Irwin, Sophie, Lim, Zixiang, Duengelhoef, Paul, Sterneck, Martina, Lohse, Ansgar W., Perez, Valeria, Trivedi, Palak, Bhandal, Khush, Mullish, Benjamin H., Manousou, Pinelopi, Provine, Nicholas M., Avitabile, Emma, Carroll, Miles, Tipton, Tom, Healy, Saoirse, Burra, Patrizia, Klenerman, Paul, Dunachie, Susanna, Kronsteiner, Barbara, Maciola, Agnieszka Katarzyna, Pasqual, Giulia, Hernandez-Gea, Virginia, Garcia-Pagan, Juan Carlos, Lampertico, Pietro, Iavarone, Massimo, Gines, Pere, Lütgehetmann, Marc, Schulze zur Wiesch, Julian, Russo, Francesco Paolo, Barnes, Eleanor, and Marjot, Thomas
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- 2024
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5. Adding Inflammatory Markers and Refining National Institute on Alcohol Abuse and Alcoholism Criteria Improve Diagnostic Accuracy for Alcohol-associated Hepatitis
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Avitabile, Emma, Díaz, Alba, Montironi, Carla, Pérez-Guasch, Martina, Gratacós-Ginès, Jordi, Hernández-Évole, Helena, Moreira, Roger K., Sehrawat, Tejasav S., Malhi, Harmeet, Olivas, Pol, Hernández-Gea, Virginia, Bataller, Ramón, Shah, Vijay H., Kamath, Patrick S., Ginès, Pere, and Pose, Elisa
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- 2023
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6. Renal Replacement Therapy for Acute Kidney Injury in Severe Alcohol-Associated Hepatitis as a Bridge to Transplant or Recovery
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Jones, Brian E., Allegretti, Andrew S., Pose, Elisa, Mara, Kristin C., Ufere, Nneka N., Avitabile, Emma, Shah, Vijay H., Kamath, Patrick S., Ginès, Pere, and Simonetto, Douglas A.
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- 2022
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7. OS-005-YI Single-cell RNA sequencing analysis in alcohol-related liver disease identifies specific cell subpopulations characterized by an inflammatory profile in alcohol-associated hepatitis
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Gratacós-Ginès, Jordi, Guillamon-Thiery, Alex, Rill, Aina, Martínez, Alicia, Ariño, Silvia, Rubio, Ana Belén, Perez-Guasch, Martina, Martinez-Sanchez, Celia, Avitabile, Emma, Soria, Anna, Juanola, Adrià, Graupera, Isabel, Coll, Mar, Bataller, Ramon, Mereu, Elisabetta, Ginès, Pere, and Pose, Elisa
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- 2024
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8. Stigmatization is common in patients with non-alcoholic fatty liver disease and correlates with quality of life
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Carol, Marta, Pérez-Guasch, Martina, Solà, Elsa, Cervera, Marta, Martínez, Sara, Juanola, Adrià, Ma, Ann T., Avitabile, Emma, Napoleone, Laura, Pose, Elisa, Graupera, Isabel, Honrubia, Maria, Korenjak, Marko, Torres, Ferran, Ginès, Pere, and Fabrellas, Núria
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Liver Cirrhosis ,Quality of life ,Stereotyping ,Multidisciplinary ,Cirrosi hepàtica ,Hepatic cirrhosis ,Liver Cirrhosis, Alcoholic ,Non-alcoholic Fatty Liver Disease ,Qualitat de vida ,Malalties del fetge ,Quality of Life ,Humans ,Liver diseases - Abstract
Background and aims Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD. Methods One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation. Results Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables. Conclusions Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients.
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- 2022
9. Sex-Associated Differences in the Modulation of Vascular Risk in Patients with Asymptomatic Carotid Stenosis
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Buratti, Laura, Balestrini, Simona, Avitabile, Emma, Altamura, Claudia, Vernieri, Fabrizio, Viticchi, Giovanna, Falsetti, Lorenzo, Provinciali, Leandro, and Silvestrini, Mauro
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- 2015
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10. Ammonium quantification in human plasma by proton nuclear magnetic resonance for staging of liver fibrosis in alcohol‐related liver disease and nonalcoholic fatty liver disease.
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Azagra, Marc, Pose, Elisa, De Chiara, Francesco, Perez, Martina, Avitabile, Emma, Servitja, Joan‐Marc, Brugnara, Laura, Ramon‐Azcón, Javier, and Marco‐Rius, Irene
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HEPATIC fibrosis ,NON-alcoholic fatty liver disease ,FATTY liver ,PROTON magnetic resonance ,NUCLEAR magnetic resonance ,ALCOHOL-induced disorders - Abstract
Liver fibrosis staging is a key element driving the prognosis of patients with chronic liver disease. Currently, biopsy is the only technique capable of diagnosing liver fibrosis in patients with alcohol‐related liver disease (ArLD) and nonalcoholic fatty liver disease (NAFLD) unequivocally. Noninvasive (e.g. plasma‐based) biomarker assays are attractive tools to diagnose and stage disease, yet must prove that they are reliable and sensitive to be used clinically. Here, we demonstrate proton nuclear magnetic resonance as a method to rapidly quantify the endogenous concentration of ammonium ions from human plasma extracts and show their ability to report upon early and advanced stages of ArLD and NAFLD. We show that, irrespective of the disease etiology, ammonium concentration is a more robust and informative marker of fibrosis stage than current clinically assessed blood hepatic biomarkers. Subject to validation in larger cohorts, the study indicates that the method can provide accurate and rapid staging of ArLD and NAFLD without the need for an invasive biopsy. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Patterns of kidney dysfunction in acute‐on‐chronic liver failure: Relationship with kidney and patients' outcome.
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Napoleone, Laura, Solé, Cristina, Juanola, Adrià, Ma, Ann T., Carol, Marta, Pérez‐Guasch, Martina, Rubio, Ana‐Belén, Cervera, Marta, Avitabile, Emma, Bassegoda, Octavi, Gratacós‐Ginès, Jordi, Morales‐Ruiz, Manuel, Fabrellas, Núria, Graupera, Isabel, Pose, Elisa, Crespo, Gonzalo, Solà, Elsa, and Ginès, Pere
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LIVER failure ,URINALYSIS ,LIPOCALIN-2 ,KIDNEY failure ,KIDNEYS - Abstract
Impairment of kidney function is common in acute‐on‐chronic liver failure (ACLF). Patterns of kidney dysfunction and their impact on kidney and patient outcomes are ill‐defined. Aims of the current study were to investigate patterns of kidney dysfunction and their impact on kidney and patient outcomes in patients with acute decompensation (AD) of cirrhosis, with or without ACLF. This prospective study includes 639 admissions for AD (232 with ACLF; 407 without) in 518 patients. Data were collected at admission and during hospitalization, and patients were followed up for 3 months. Urine samples were analyzed for kidney biomarkers. Most patients with ACLF (92%) had associated acute kidney injury (AKI), in most cases without previous chronic kidney disease (CKD), whereas some had AKI‐on‐CKD (70% and 22%, respectively). Prevalence of AKI in patients without ACLF was 35% (p < 0.001 vs. ACLF). Frequency of CKD alone was low and similar in both groups (4% and 3%, respectively); only a few patients with ACLF (4%) had no kidney dysfunction. AKI in ACLF was associated with poor kidney and patient outcomes compared with no ACLF (AKI resolution: 54% vs. 89%; 3‐month survival: 51% vs. 86%, respectively; p < 0.001 for both). Independent predictive factors of 3‐month survival were Model for End‐Stage Liver Disease–Sodium score, ACLF status, and urine neutrophil gelatinase–associated lipocalin (NGAL). AKI is almost universal in patients with ACLF, sometimes associated with CKD, whereas CKD alone is uncommon. Prognosis of AKI depends on ACLF status. AKI without ACLF has good prognosis. Best predictors of 3‐month survival are MELD‐Na, ACLF status, and urine NGAL. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study
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European Association for the Study of the Liver, National Institutes of Health (US), North Carolina State University, National Institute for Health Research (UK), National Health Service (UK), Marjot, Thomas, Moon, Andrew M., Cook, Jonathan A., Abd-Elsalam, Sherief, Aloman, Costica, Armstrong, Matthew J., Pose, Elisa, Brenner, Erica J., Cargill, Tamsin, Catana, Maria-Andreea, Dhanasekaran, Renumathy, Eshraghian, Ahad, García-Juárez, Ignacio, Gill, Upkar S., Jones, Patricia D., Kennedy, James, Marshall, Aileen, Matthews, Charmaine, Mells, George, Mercer, Carolyn, Perumalswami, Ponni V., Avitabile, Emma, Qi, Xialong, Su, Feng, Ufere, Nneka N., Wong, Yu Jun, Zheng, Ming-Hua, Barnes, Eleanor, Barritt, Alfred S., Webb, Gwilym J., European Association for the Study of the Liver, National Institutes of Health (US), North Carolina State University, National Institute for Health Research (UK), National Health Service (UK), Marjot, Thomas, Moon, Andrew M., Cook, Jonathan A., Abd-Elsalam, Sherief, Aloman, Costica, Armstrong, Matthew J., Pose, Elisa, Brenner, Erica J., Cargill, Tamsin, Catana, Maria-Andreea, Dhanasekaran, Renumathy, Eshraghian, Ahad, García-Juárez, Ignacio, Gill, Upkar S., Jones, Patricia D., Kennedy, James, Marshall, Aileen, Matthews, Charmaine, Mells, George, Mercer, Carolyn, Perumalswami, Ponni V., Avitabile, Emma, Qi, Xialong, Su, Feng, Ufere, Nneka N., Wong, Yu Jun, Zheng, Ming-Hua, Barnes, Eleanor, Barritt, Alfred S., and Webb, Gwilym J.
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Background & Aims: Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation, leading to concerns that affected patients may be at risk of adverse outcomes following SARS-CoV-2 infection. We aimed to determine the impact of COVID-19 on patients with pre-existing liver disease, which currently remains ill-defined. Methods: Between 25th March and 8th July 2020, data on 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) were collected by 2 international registries and compared to data on non-CLD patients with SARS-CoV-2 from a UK hospital network. Results: Mortality was 32% in patients with cirrhosis compared to 8% in those without (p <0.001). Mortality in patients with cirrhosis increased according to Child-Pugh class (A [19%], B [35%], C [51%]) and the main cause of death was from respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (odds ratio [OR] 1.02; 1.01–1.04), Child-Pugh A (OR 1.90; 1.03–3.52), B (OR 4.14; 2.4–7.65), or C (OR 9.32; 4.80–18.08) cirrhosis and alcohol-related liver disease (OR 1.79; 1.03–3.13). Compared to patients without CLD (n = 620), propensity-score-matched analysis revealed significant increases in mortality in those with Child-Pugh B (+20.0% [8.8%–31.3%]) and C (+38.1% [27.1%–49.2%]) cirrhosis. Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of whom 21% had no respiratory symptoms. Half of those with hepatic decompensation had acute-on-chronic liver failure. Conclusions: In the largest such cohort to date, we demonstrate that baseline liver disease stage and alcohol-related liver disease are independent risk factors for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic. Lay summary: This international registry study demonstrates that patients with cirrhosis are at increased
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- 2021
13. Cognitive Deterioration in Bilateral Asymptomatic Severe Carotid Stenosis
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Buratti, Laura, Balucani, Clotilde, Viticchi, Giovanna, Falsetti, Lorenzo, Altamura, Claudia, Avitabile, Emma, Provinciali, Leandro, Vernieri, Fabrizio, and Silvestrini, Mauro
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- 2014
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14. FRI-437 - Beneficial effects of a screening programme for alcohol-related liver fibrosis with transient elastography in people with alcohol use disorder promoting alcohol abstinence
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Avitabile, Emma, Evole, Helena Hernandéz, Gratacos, Jordi, Bruguera, Pol, Ortega, Lluisa, Lligoña, Anna, Perez, Martina, Rubio, Ana Belén, Bataller, Ramon, Ginès, Pere, Lopez, Hugo, and Pose, Elisa
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- 2023
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15. FRI-431 - Patients with alcohol-related cirrhosis who recompensate on follow-up have a characteristic metabolomic profile with differential concentrations of lipid and amino-acid metabolites
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Hernàndez-Èvole, Helena, Gratacos, Jordi, Avitabile, Emma, Lozano, Juanjo, Perez, Martina, Sidorova, Julia, Thiery, Alex Guillamon, Juanola, Adria, Soria, Anna, Graupera, Isabel, Rubio, Ana Belén, Cervera, Marta, Carol, Marta, Fabrellas, Núria, Ginès, Pere, and Pose, Elisa
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- 2023
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16. Sequential changes in urinary biomarker levels in patients with cirrhosis and severe hepatorenal syndrome.
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Solé, Cristina, Ma, Ann T., Solà, Elsa, Carol, Marta, Fabrellas, Núria, Juanola, Adrià, Napoleone, Laura, Gratacós‐Ginès, Jordi, Bassegoda, Octavi, Cervera, Marta, Pérez, Martina, Rubio, Ana Belén, Avitabile, Emma, Morales‐Ruiz, Manuel, Graupera, Isabel, Pose, Elisa, Kamath, Patrick S., and Ginès, Pere
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HEPATORENAL syndrome ,ACUTE kidney failure ,BIOMARKERS ,CIRRHOSIS of the liver ,LIPOCALIN-2 ,LIVER transplantation - Abstract
Whether tubular injury develops in patients with acute kidney injury owing to hepatorenal syndrome (AKI‐HRS) is controversial. We performed repeated measurements of biomarkers of tubular injury during a 14‐day period in 60 patients with cirrhosis and AKI (34 with AKI‐HRS meeting the classical definition of type 1 HRS and 26 with AKI owing to acute tubular necrosis, AKI‐ATN). Nineteen of 34 patients had resolution of AKI‐HRS, while the remainder had persistent AKI‐HRS. The persistence of AKI‐HRS was associated with remarkably high short‐term mortality. There were no significant differences in urinary NGAL or IL‐18 between patients with resolution vs those with persistent AKI‐HRS throughout the 14‐day period. By contrast, biomarker levels were significantly lower in AKI‐HRS, even if persistent, compared to AKI‐ATN. These findings are highly suggestive of lack of significant tubular injury in AKI‐HRS and could be of value in the clinical decision between combined liver–kidney or liver transplantation alone in patients with cirrhosis and AKI candidates to transplantation. [ABSTRACT FROM AUTHOR]
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- 2021
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17. The Use of Rifaximin in Patients With Cirrhosis.
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Caraceni, Paolo, Vargas, Victor, Solà, Elsa, Alessandria, Carlo, de Wit, Koos, Trebicka, Jonel, Angeli, Paolo, Mookerjee, Rajeshwar P., Durand, François, Pose, Elisa, Krag, Aleksander, Bajaj, Jasmohan S., Beuers, Ulrich, Ginès, Pere, Juanola, Adrià, Napoleone, Laura, Carol, Marta, Avitabile, Emma, Thu, Ann Ma, and Cervera, Marta
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- 2021
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18. SAT524 - Prospective evaluation of the EASL clinical guidelines algorithm of management of acute kidney injury in cirrhosis
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Ma, Ann T, Solé, Cristina, Escude, Laia, Juanola, Adria, Napoleone, Laura, Avitabile, Emma, Perez, Martina, Carol, Marta, Rubio, Ana Belén, Cervera, Marta, Bassegoda, Octavi, Gratacós-Gines, Jordi, Soria, Anna, Fabrellas, Núria, Graupera, Isabel, Pose, Elisa, Morales-Ruiz, Manuel, Poch, Esteban, Solà, Elsa, and Ginès, Pere
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- 2022
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19. SAT522 - Blood metabolomics unveils mitochondrial dysfunction as a potential key feature in the pathogenesis of hepatorenal syndrome
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Ma, Ann T, Juanola, Adria, Perez-Guasch, Martina, Carol, Marta, Gratacós-Gines, Jordi, Napoleone, Laura, Rubio, Ana Belén, Avitabile, Emma, Soria, Anna, Cervera, Marta, Bassegoda, Octavi, Riba, Carlota, Fabrellas, Núria, Graupera, Isabel, Lozano, Juanjo, Pose, Elisa, Morales-Ruiz, Manuel, Solà, Elsa, and Ginès, Pere
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- 2022
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20. Interaction between metabolic syndrome and alcohol consumption, risk factors of liver fibrosis: A population‐based study.
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Pose, Elisa, Pera, Guillem, Torán, Pere, Gratacós‐Ginès, Jordi, Avitabile, Emma, Expósito, Carmen, Díaz, Alba, Graupera, Isabel, Rubio, Ana B., Ginès, Pere, Fabrellas, Núria, and Caballeria, Llorenç
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ALCOHOL drinking ,FIBROSIS ,METABOLIC syndrome ,LIVER ,REFERENCE values ,ALCOHOL-induced disorders - Abstract
Background and aims: Alcohol and metabolic syndrome (MS) coexist frequently as cofactors of liver disease. Previous studies suggest a deleterious effect of MS in advanced alcohol‐related liver disease (ArLD). However, it is unknow whether MS can increase the risk of liver fibrosis in early stages of ArLD. The aim of this study was to investigate the effect of MS on liver fibrosis in subjects with alcohol consumption from a population‐based cohort. Methods: The number of subjects include 1760(58%) of 3014 who were randomly selected from the community consumed alcohol and were classified as current drinkers, divided in moderate (n = 1222) or high‐risk drinkers (n = 275) (>21 units/week men, >14 units/week women for high‐risk drinkers), or former drinkers (n = 263). Liver fibrosis was estimated by measuring liver stiffness(LS) with transient elastography (TE). Results: Prevalence of significant LS using cutoff values of TE of 8 and 9.1kPa was increased in high‐risk compared with moderate or former drinkers and lifetime abstainers. In subjects with alcohol consumption, LS was associated with male gender, AST, ALT, years of consumption, and MS. In high‐risk drinkers, MS and intensity of consumption were the only factors associated with significant LS (OR 3.7 and 4.6 for LS ≥ 8 kPa and 3.9 and 9.2 kPa for LS ≥ 9.1 kPa, respectively). Presence of significant liver fibrosis in the liver biopsy was higher among high‐risk as compared with moderate or former drinkers. Conclusion: MS increases the risk of liver fibrosis in subjects with alcohol consumption. Among high‐risk drinkers, only MS and consumption of high amount of alcohol are associated with risk of liver fibrosis. [ABSTRACT FROM AUTHOR]
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- 2021
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21. Circulating Extracellular Vesicles Carrying Sphingolipid Cargo for the Diagnosis and Dynamic Risk Profiling of Alcoholic Hepatitis.
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Sehrawat, Tejasav S., Arab, Juan P., Liu, Mengfei, Amrollahi, Pouya, Wan, Meihua, Fan, Jia, Nakao, Yasuhiko, Pose, Elisa, Navarro‐Corcuera, Amaia, Dasgupta, Debanjali, Liao, Chieh‐Yu, He, Li, Mauer, Amy S., Avitabile, Emma, Ventura‐Cots, Meritxell, Bataller, Ramon A., Sanyal, Arun J., Chalasani, Naga P., Heimbach, Julie K., and Watt, Kymberly D.
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- 2021
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22. THU066 - Non-invasive criteria for diagnosis of alcoholic hepatitis: use in clinical practice and correlation with prognosis.
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Avitabile, Emma, Pose, Elisa, Graupera, Isabel, Carol, Marta, Perez, Martina, Cervera, Marta, Fabrellas, Núria, Juanola, Adria, Bassegoda, Octavi, Solé, Cristina, Solà, Elsa, and Ginès, Pere
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HEPATITIS , *PROGNOSIS , *ALCOHOLIC liver diseases , *DIAGNOSIS - Published
- 2020
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23. Urinary L-FABP is a promising prognostic biomarker of ACLF and mortality in patients with decompensated cirrhosis.
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Juanola, Adrià, Graupera, Isabel, Elia, Chiara, Piano, Salvatore, Solé, Cristina, Carol, Marta, Pérez-Guasch, Martina, Bassegoda, Octavi, Escudé, Laia, Rubio, Ana-Belén, Cervera, Marta, Napoleone, Laura, Avitabile, Emma, Ma, Ann T., Fabrellas, Núria, Pose, Elisa, Morales-Ruiz, Manuel, Jiménez, Wladimiro, Torres, Ferran, and Crespo, Gonzalo
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LIPOCALIN-2 , *FATTY acid-binding proteins , *ACUTE kidney failure , *BIOMARKERS , *CIRRHOSIS of the liver , *NECROSIS - Abstract
Decompensated cirrhosis (DC) is associated with high mortality, mainly owing to the development of acute-on-chronic liver failure (ACLF). Identifying the patients with DC who are at high risk of mortality and ACLF development is an unmet clinical need. Liver fatty acid-binding protein (L-FABP) is expressed in several organs and correlates with liver and systemic inflammation. Herein, we aimed to assess the prognostic value of L-FABP in patients with DC. A prospective series of 444 patients hospitalized for DC was divided into 2 cohorts: study cohort (305 patients) and validation cohort (139 patients). L-FABP was measured in urine and plasma samples collected at admission. Neutrophil gelatinase-associated lipocalin (NGAL) was also measured in urine samples for comparison. Urine but not plasma L-FABP correlated with 3-month survival on univariate analysis. On multivariate analysis, urine L-FABP and model for end-stage liver disease (MELD)-Na were the only independent predictors of prognosis. Urine L-FABP levels were higher in patients with ACLF than in those without and also predicted the development of ACLF, together with MELD-Na, during follow-up. In patients with ACLF, urine L-FABP correlated with liver, coagulation, and circulatory failure. Urine L-FABP levels were also increased in patients with acute kidney injury, particularly in those with acute tubular necrosis. The ability of urinary L-FABP to predict survival and ACLF development was confirmed in the validation cohort. Urine NGAL predicted outcome on univariate but not multivariate analysis. Urinary L-FABP levels are independently associated with the 3-month clinical course in patients with DC, in terms of mortality and ACLF development. Urinary L-FABP is a promising prognostic biomarker for patients with DC. Increased levels of liver fatty acid-binding protein (L-FABP), a protein related to lipid metabolism, have been associated with liver-related diseases. The present study analyzed urinary L-FABP levels in 2 independent groups of patients with decompensated cirrhosis and showed that higher urinary L-FABP levels correlated with increased mortality and risk of acute-on-chronic liver failure development. Therefore, urinary L-FABP levels could be useful as a new tool to predict complications in patients with decompensated cirrhosis. [Display omitted] • L-FABP is a mediator of lipid metabolism and has been associated with liver injury. • Urinary L-FABP and MELD-Na were associated with 90-day mortality in patients with decompensated cirrhosis. • Urinary L-FABP correlates with ACLF grade and liver, coagulation and circulatory failures. • Moreover, urinary L-FABP was related to the development of ACLF. [ABSTRACT FROM AUTHOR]
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- 2022
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24. A notable proportion of liver transplant candidates with alcohol-related cirrhosis can be delisted because of clinical improvement.
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Pose, Elisa, Torrents, Abiguei, Reverter, Enric, Perez-Campuzano, Valeria, Campos-Varela, Isabel, Avitabile, Emma, Gratacós-Ginès, Jordi, Castellote, Jose, Castells, Lluis, Colmenero, Jordi, Tort, Jaume, Ginès, Pere, and Crespo, Gonzalo
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LIVER transplantation , *CIRRHOSIS of the liver , *MULTIVARIATE analysis , *PLATELET count , *LIVER diseases - Abstract
To what extent patients with alcohol-related decompensated cirrhosis can improve until recovery from decompensation remains unclear. We aimed to investigate the probability of recovery and delisting due to improvement in patients with alcohol-related decompensated cirrhosis on the waiting list (WL) for liver transplantation (LT). We conducted a registry-based, multicenter, retrospective study including all patients admitted to the LT WL in Catalonia (Spain) with the indication of alcohol-, HCV-, cholestasis- or non-alcoholic steatohepatitis-related decompensated cirrhosis between January 2007 and December 2018. Competing-risk analysis was used to investigate variables associated with delisting due to improvement in patients with alcohol-related decompensated cirrhosis. Criteria for delisting after improvement were not predefined. Outcomes of patients after delisting were also studied. One-thousand and one patients were included, 420 (37%) with alcohol-related decompensated cirrhosis. Thirty-six (8.6%) patients with alcohol-related decompensated cirrhosis were delisted after improvement at a median time of 29 months after WL admission. Lower model for end-stage liver disease (MELD) score, higher platelets and either female sex or lower height were independently associated with delisting due to improvement, while time of abstinence did not reach statistical significance in multivariate analysis (p = 0.055). Five years after delisting, the cumulative probability of remaining free from liver-related death or LT was 76%, similar to patients with HCV-related decompensated cirrhosis delisted after improvement. A significant proportion of LT candidates with alcohol-related cirrhosis can be delisted due to improvement, which is predicted by low MELD score and higher platelet count at WL admission. Women also have a higher probability of being delisted after improvement, partially due to reduced early access to LT for height discrepancies. Early identification of patients with potential for improvement may avoid unnecessary transplants. Patients with alcohol-related cirrhosis can improve until being delisted in approximately 9% of cases. Low model for end-stage liver disease score and high platelet levels at admission predict delisting after improvement, and women have higher probabilities of being delisted due to improvement. Long-term outcomes after delisting are generally favorable. [Display omitted] • Around 9% of patients with alcohol-related cirrhosis are delisted for improvement. • MELD score is the main determinant of improvement. • Women have higher probabilities of being delisted for improvement. • Outcomes after delisting are globally favorable and affected by alcohol relapse. [ABSTRACT FROM AUTHOR]
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- 2021
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25. Cognitive Deterioration in Bilateral Asymptomatic Severe Carotid Stenosis
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Emma Avitabile, Laura Buratti, Leandro Provinciali, Claudia Altamura, Clotilde Balucani, F. Vernieri, M. Silvestrini, Giovanna Viticchi, Lorenzo Falsetti, Buratti, Laura, Balucani, Clotilde, Viticchi, Giovanna, Falsetti, Lorenzo, Altamura, Claudia, Avitabile, Emma, Provinciali, Leandro, Vernieri, Fabrizio, and Silvestrini, Mauro
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Risk ,medicine.medical_specialty ,Ultrasonography, Doppler, Transcranial ,Carotid Stenosi ,Hemodynamics ,Carotid Intima-Media Thickness ,Severity of Illness Index ,Asymptomatic ,Follow-Up Studie ,Cognition Disorder ,mild cognitive impairment ,Carotid Intima-Media Thickne ,medicine.artery ,Internal medicine ,Severity of illness ,medicine ,Humans ,Carotid Stenosis ,Hemodynamic ,Common carotid artery ,Effects of sleep deprivation on cognitive performance ,Pathological ,Aged ,Psychiatric Status Rating Scales ,Advanced and Specialized Nursing ,business.industry ,Brain ,ultrasonography ,Psychiatric Status Rating Scale ,medicine.disease ,Surgery ,Transcranial Doppler ,Stenosis ,Cerebrovascular Circulation ,Cardiology ,Neurology (clinical) ,medicine.symptom ,Cognition Disorders ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Human - Abstract
Background and Purpose— This study aimed to monitor cognitive performance during a 3-year period in subjects with bilateral asymptomatic severe internal carotid artery stenosis and to explore the role of cerebral hemodynamics and atherosclerotic disease in the development of cognitive dysfunction. Methods— One hundred fifty-nine subjects with bilateral asymptomatic severe internal carotid artery stenosis were included and prospectively evaluated for a 3-year period. At entry, demographics, vascular risk profile, and pharmacological treatments were defined. Cognitive status was evaluated using the Mini-Mental State Examination at baseline and at follow-up. Cerebral hemodynamics was assessed by transcranial Doppler–based breath-holding index test. As a measure of the extent of systemic atherosclerotic disease, common carotid artery intima-media thickness was measured. A cutoff for pathological values was set at 0.69 for breath-holding index and 1.0 mm for intima-media thickness. Results— The risk of decreasing in Mini-Mental State Examination score increased progressively from patients with bilaterally normal to those with unilaterally abnormal breath-holding index, reaching the highest probability in patients with bilaterally abnormal breath-holding index ( P Conclusions— Our findings suggest that patients with asymptomatic bilateral severe internal carotid artery stenosis may be at risk of developing cognitive impairment. The evaluation of the hemodynamic status, besides providing insights about the possible mechanism behind the cognitive dysfunction present in carotid atherosclerotic disease, may be of help for the individuation of subjects deserving earlier and more aggressive treatments.
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- 2014
26. SAT107 - Lack of evidence of significant tubular injury in patients with cirrhosis and persistent hepatorenal syndrome. implications for liver transplantation.
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Martí, Cristina Solé, Solà, Elsa, Carol, Marta, Fabrellas, Núria, Juanola, Adria, Napoleone, Laura, Huelin, Patricia, Cervera, Marta, Perez, Martina, Avitabile, Emma, Graupera, Isabel, Pose, Elisa, and Ginès, Pere
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HEPATORENAL syndrome , *LIVER transplantation , *CIRRHOSIS of the liver , *WOUNDS & injuries , *EVIDENCE - Published
- 2020
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27. THU072 - Delisting of liver transplant candidates after improvement in alcohol-related decompensated cirrhosis: a multicentric study on incidence and outcomes.
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Pose, Elisa, Torrents, Abiguei, Perez-Campuzano, Valeria, Campos-Varela, Isabel, Avitabile, Emma, Alonso, José Castellote, Castells, Lluis, Colmenero, Jordi, Tort, Jaume, Ginès, Pere, and Crespo, Gonzalo
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LIVER transplantation , *LISTING of securities , *CIRRHOSIS of the liver , *ALCOHOLIC liver diseases - Published
- 2020
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28. Two-year multidisciplinary follow-up of COVID-19 patients requiring invasive and noninvasive respiratory support.
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Tresoldi M, Zangrillo A, Belletti A, Ramirez GA, Bozzolo E, Guzzo F, Marinosci A, Fominskiy EV, DA Prat V, Marmiere M, Palumbo D, Del Prete L, D'Amico F, Bellino C, Morando D, Saracino M, Ortalda A, Castelli E, Rocchi M, Baiardo Redaelli M, Scotti R, DI Terlizzi G, Azzolini ML, Guaschino G, Avitabile E, Borghi G, Soddu D, Dagna L, Landoni G, and DE Cobelli F
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- Humans, Follow-Up Studies, Quality of Life, Respiration, Artificial methods, COVID-19 complications, COVID-19 therapy, Noninvasive Ventilation methods
- Abstract
Background: COVID-19 patients frequently develop respiratory failure requiring mechanical ventilation. Data on long-term survival of patients who had severe COVID-19 are insufficient. We assessed and compared two-year survival, CT imaging, quality of life, and functional recovery of COVID-19 ARDS patients requiring respiratory support with invasive (IMV) versus noninvasive ventilation (NIV)., Methods: Patients with COVID-19 pneumonia admitted up to May 28
th , 2020, who required IMV or NIV, and survived to hospital discharge were enrolled. Patients were contacted two years after discharge to assess vital status, functional, psychological, and cognitive outcomes using validated scales. Patients with persistent respiratory symptoms or high burden of residual lung damage at previous CT scan received a two-year chest CT scan., Results: Out of 61 IMV survivors, 98% were alive at two-year follow-up, and 52 completed the questionnaire. Out of 82 survivors receiving NIV only, 94% were alive at two years, and 47 completed the questionnaire. We found no major differences between invasively and noninvasively ventilated patients, with overall acceptable functional recovery. Among the 99 patients completing the questionnaire, 23 have more than moderate exertional dyspnea. Chest CT scans showed that 4 patients (all received IMV) had fibrotic-like changes., Conclusions: Patients who received mechanical ventilation due to COVID-19 and were discharged from hospital had a 96% survival rate at the two-year follow-up. There was no difference in overall recovery and quality of life between patients who did and did not require IMV, although respiratory morbidity remains high.- Published
- 2023
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29. Stigmatization is common in patients with non-alcoholic fatty liver disease and correlates with quality of life.
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Carol M, Pérez-Guasch M, Solà E, Cervera M, Martínez S, Juanola A, Ma AT, Avitabile E, Napoleone L, Pose E, Graupera I, Honrubia M, Korenjak M, Torres F, Ginès P, and Fabrellas N
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- Humans, Liver Cirrhosis complications, Liver Cirrhosis, Alcoholic complications, Stereotyping, Non-alcoholic Fatty Liver Disease complications, Quality of Life
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Background and Aims: Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD., Methods: One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation., Results: Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables., Conclusions: Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients., Competing Interests: Disclosures: PG reports Investigator Research grant and Advisory Board for Grífols, Investigator Research grant and Advisory Board for Gilead, Investigator Research grant from Mallinckrodt, Advisory Board for Promethera, Advisory Board for Martin-Pharmaceuticals, grants from Ferring-Pharmaceuticals, grants and Advisory Board work from Sequana, all outside the submitted work. The other authors have declared no conflict of interests.
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- 2022
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30. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study.
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Marjot T, Moon AM, Cook JA, Abd-Elsalam S, Aloman C, Armstrong MJ, Pose E, Brenner EJ, Cargill T, Catana MA, Dhanasekaran R, Eshraghian A, García-Juárez I, Gill US, Jones PD, Kennedy J, Marshall A, Matthews C, Mells G, Mercer C, Perumalswami PV, Avitabile E, Qi X, Su F, Ufere NN, Wong YJ, Zheng MH, Barnes E, Barritt AS 4th, and Webb GJ
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- Disease Progression, Female, Global Health statistics & numerical data, Hospitalization statistics & numerical data, Humans, Liver Function Tests methods, Male, Middle Aged, Mortality, Registries statistics & numerical data, Risk Assessment methods, Risk Factors, SARS-CoV-2 isolation & purification, United Kingdom epidemiology, Acute-On-Chronic Liver Failure diagnosis, Acute-On-Chronic Liver Failure epidemiology, COVID-19 mortality, COVID-19 therapy, Liver Cirrhosis diagnosis, Liver Cirrhosis epidemiology, Liver Cirrhosis etiology
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Background & Aims: Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation, leading to concerns that affected patients may be at risk of adverse outcomes following SARS-CoV-2 infection. We aimed to determine the impact of COVID-19 on patients with pre-existing liver disease, which currently remains ill-defined., Methods: Between 25th March and 8th July 2020, data on 745 patients with CLD and SARS-CoV-2 (including 386 with and 359 without cirrhosis) were collected by 2 international registries and compared to data on non-CLD patients with SARS-CoV-2 from a UK hospital network., Results: Mortality was 32% in patients with cirrhosis compared to 8% in those without (p <0.001). Mortality in patients with cirrhosis increased according to Child-Pugh class (A [19%], B [35%], C [51%]) and the main cause of death was from respiratory failure (71%). After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (odds ratio [OR] 1.02; 1.01-1.04), Child-Pugh A (OR 1.90; 1.03-3.52), B (OR 4.14; 2.4-7.65), or C (OR 9.32; 4.80-18.08) cirrhosis and alcohol-related liver disease (OR 1.79; 1.03-3.13). Compared to patients without CLD (n = 620), propensity-score-matched analysis revealed significant increases in mortality in those with Child-Pugh B (+20.0% [8.8%-31.3%]) and C (+38.1% [27.1%-49.2%]) cirrhosis. Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of whom 21% had no respiratory symptoms. Half of those with hepatic decompensation had acute-on-chronic liver failure., Conclusions: In the largest such cohort to date, we demonstrate that baseline liver disease stage and alcohol-related liver disease are independent risk factors for death from COVID-19. These data have important implications for the risk stratification of patients with CLD across the globe during the COVID-19 pandemic., Lay Summary: This international registry study demonstrates that patients with cirrhosis are at increased risk of death from COVID-19. Mortality from COVID-19 was particularly high among patients with more advanced cirrhosis and those with alcohol-related liver disease., Competing Interests: Conflicts of interest The authors declare no conflicts of interest. Please refer to the accompanying ICMJE disclosure forms for further details., (Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
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- 2021
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