Irsan Hasan
Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta

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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Survival COVID-19 in Adult Patients with Liver Cirrhosis Gita Aprilicia; Syahrizal Syarif; Kemal Fariz Kalista; Andri Sanityoso Sulaiman; Irsan Hasan; Cosmas Rinaldi A Lesmana; Juferdy Kurniawan; Chyntia Olivia Maurine Jasirwan; Saut Horas Hatoguan Nababan; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 2 (2021): VOLUME 22, NUMBER 2, August 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (672.017 KB) | DOI: 10.24871/2222021124-129

Abstract

Background: COVID-19 is a disease caused by infection of SARS-CoV-2 virus which leads to mortality due to respiratory failure. The progression of COVID-19 is more severe in patients with pre-existence morbidities, including liver disease. Recently, a few studie showed that liver cirrhosis patients with COVID-19 had a higher risk of mortality rather than liver cirrhosis patients without COVID-19 infection. Nevertheless, the study of survival COVID-19 in a patient with underlying liver cirrhosis is still limited. The aim of this study is to evaluate the survival of COVID-19 in adult patients with liver cirrhosisMethod: An observational study in Cipto Mangunkusumo Hospital was conducted. Patients with underlying liver cirrhosis between March 2020-January 2021 with positive confirmation of COVID-19 were enrolled in this study. Liver cirrhosis patients without COVID-19 were enrolled as a comparison. Both liver cirrhosis patients with and without COVID-19 were follow up at the time of hospital admission until 30 days outcome. Kaplan Meier and a log-rank test were conducted to evaluate the comparison of survival rate in liver cirrhosis patients with and without COVID-19. Multivariate Cox Proportional Hazard was conducted to identify the independent risk factors related to survival.Results: There were 22 liver cirrhosis patients with COVID-19 and 116 liver cirrhosis patients included in this study. Presentation of gender and age similar both of them. Predominantly males with average age were 57 years ± 13,60 for cirrhosis with COVID-19 patients and 53 years ± 12,75 for without COVID-19. The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19  (35.8% vs. 67.2%, p-value 0.001). Median survival of liver cirrhosis patients with COVID-19 was 4 days (95% CI: 1-8 days), while median survival of liver cirrhosis patients without COVID-19 couldn’t be reached since the survival rate of this group above 50%. Final model Cox PH showed that liver cirrhosis with COVID-19 (HR: 8.99; CI 95%: 4.55 – 17.80, p-value 0.001) and Child-Pugh class C (HR: 5.61; 95% CI: 2.76 – 11.40, p-value 0.001) were the independent risk factors associated with poor survival.Conclusion: The survival rate of liver cirrhosis patients with COVID-19 lower than liver cirrhosis patients without COVID-19. Liver cirrhosis with COVID-19 and Child-Pugh class C were associated with poor survival.
Sarcopenia are Associated with Poor Performance Status in Indonesian Patients with Hepatocellular Carcinoma Hendra Koncoro; Irsan Hasan; C Rinaldi Lesmana; Humala Prika Aditama; Thariqah Salamah; Aulia Rizka; Edy Rizal Wahyudi; Hamzah Shatri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (614.006 KB) | DOI: 10.24871/231202217-23

Abstract

Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. Sarcopenia can be assessed by using skeletal muscle index (SMI), measured on transverse CT images at the third lumbar vertebra (L3). HCC staging consists of liver function assessment and Eastern Cooperative Oncology Group performance status (ECOG-PS).                   ECOG-PS can reflect physical function. This study was aimed to describe the proportion of sarcopenia among adults, using Japan Society of Hepatology criteria and explore association between sarcopenia and poor performance status.Method: The study was conducted in a tertiary hospital during January – October 2021. SMI were evaluated using computed tomography images of L3 in 85 HCC patients. Clinical, laboratory and body composition data were analyzed using bivariate analysis. Logistic regression was performed to obtain an independent association between ECOG-PS and sarcopenic status of HCC patients.Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 49,4% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 4.169 (CI 95% = 1.504-11,555), p 0,006).Conclusion: Sarcopenia has high proportion in HCC patients. There were strong association between ECOG-PS and sarcopenia in HC.