COVID-19 risk, disparities and outcomes in patients with chronic liver disease in the United States

Abstract Background Scientific evidence is lacking regarding the risk of patients with chronic liver disease (CLD) for COVID-19, and how these risks are affected by age, gender and race. Methods We performed a case-control study of electronic health records of 62.2 million patients (age >18 years) in the US up to October 1st, 2020, including 1,034,270 patients with CLD, 16,530 with COVID-19, and 820 with both COVID-19 and CLD. We assessed the risk, disparities, and outcomes of COVID-19 in patients with six major CLDs. Findings Patients with a recent medical encounter for CLD were at significantly increased risk for COVID-19 compared with patients without CLD, with the strongest effect in patients with chronic non-alcoholic liver disease [adjusted odd ratio (AOR)=13.11, 95% CI: 12.49–13.76, p  Interpretation Patients with CLD, especially African Americans, were at increased risk for COVID-19, highlighting the need to protect these patients from exposure to virus infection. Funding National Institutes of Health (AG057557, AG061388, AG062272, 1UL1TR002548-01), American Cancer Society (RSG-16-049-01-MPC).