(468) Outcomes of Fulminant Hepatitis in Patients With COVID-19 Infection: 2020-2021 Nationwide Analysis

Tuesday, February 25, 2025

11:15am – 12:15pm Eastern Time

Location: Connections Central - RST 12

First Author(s)

Antony Arumairaj, MD

New York City Health and Hospitals Coporation.
New York Medical College
New York, New York, United States

Co-Author(s)

JM

Joseph Mattana, MD

Department Chair
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States
SC

Shobhana Chaudhari, MD

Program director
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States
NT

Natoushka Trenard, MD

Attending Physician
New York Medical College, NYC Health and Hospitals/Metropolitan.
New York, New York, United States

Introduction: Clinical studies have reported varying degrees of liver injury with COVID-19 infection, but there have been only a few case reports of fulminant hepatitis from COVID-19 infection. This National Inpatient Sample (NIS) study aimed to determine the clinical and mortality outcomes of fulminant hepatitis in patients hospitalized with COVID-19 infection.

Methods: We identified patients hospitalized with COVID-19 infection and fulminant hepatitis from the 2020-2021 NIS database. STATA/MP 17.0 software was used for statistical analysis. Multivariate logistic regression analysis was performed.

Results: 818,011 patients were hospitalized with COVID-19 infection, and 81,656 patients were hospitalized with fulminant hepatitis. The patients with fulminant hepatitis were stratified based on their COVID-19 status. There were 72,640 patients with fulminant hepatitis without COVID-19 infection and 9,016 patients with fulminant hepatitis from COVID-19 infection. Caucasians constituted the largest ethnic group in both groups. Patients in the lowest national income quartile and those with Medicaid insurance constituted the largest group among the national income quartile and insurance groups, respectively, in both groups. The length of hospital stay among patients with fulminant hepatitis from COVID-19 infection was 17.5 days; for those without COVID-19 infection, it was 10.4 days. This difference was statistically significant, with a P value of < 0.001. The unadjusted odds ratio (OR) of invasive ventilation in patients with fulminant hepatitis from COVID-19 infection was 4.05, and the adjusted OR after adjustment for age, sex, race, Charlson comorbid index, national income quartile, and insurance was 3.76, with a P-value of < 0.001. The unadjusted OR of mortality among patients with fulminant hepatitis from COVID-19 infection was 4.28, and the adjusted OR of mortality was 4.39 with a P-value of < 0.001, thereby indicating that the mortality rate among patients with fulminant hepatitis from COVID-19 infection was more than four times higher than those without COVID-19 infection.

Conclusions: Our analysis of the NIS database suggests that the COVID-19 infection resulted in more severe outcomes of fulminant hepatitis with a longer stay, higher need for invasive ventilation, and higher mortality rate.