COVID-19 in patients with cirrhosis: understanding adverse impact.

We read with great interest the article by Bajaj et al 1 comparing the outcomes of hospitalised patients with COVID-19+cirrhosis with that of patients with cirrhosis alone and COVID-19 alone. The authors found that the risk of mortality in patients with COVID-19+cirrhosis was not significantly higher than in patients with cirrhosis alone, though it was higher than patients with COVID-19 alone. The findings of the current study add to the existing understanding of the effects of COVID-19 in patients with cirrhosis;2–5 however, interpretation of such results must be mindful of two facts: first, the study subjects were not properly matched with regard to the severity of cirrhosis; and second, small and unbalanced sample size comparisons may lead to erroneous conclusions. Model for end-stage liver disease (MELD) score is a reliable marker of severity of liver disease and predictor of mortality in patients with cirrhosis. In this study, patients with COVID-19+cirrhosis had …