The association of chronic liver disorders with exacerbation of symptoms and complications related to COVID‐19: A systematic review and meta‐analysis of cohort studies

Introduction The aim of this review was to combine the results of published cohort studies to determine the exact association between chronic liver disorders, and the severe form of COVID-19, and its associated complications. Methods This meta-analysis employed a keyword search (COVID-19 and chronic liver disorders) using PubMed (Medline), Scopus, Web of Sciences, and Embase (Elsevier). All articles related from January 2019 to May 2022 were reviewed. The STATA software was used for analysis. Results The risk of death in COVID-19 patients with chronic liver disorders was higher than in ones without the chronic liver disease (RR: 1.52; CI 95%: 1.46-1.57; I-2: 86.14%). Also, the risk of acute respiratory distress syndrome (ARDS) and hospitalization in COVID-19 patients with chronic liver disorders was higher than in ones without the chronic liver disease ([RR: 1.65; CI 95%: 1.09-2.50; I-2: 0.00%] and [RR: 1.39; CI 95%: 1.23-1.58; I-2: 0.20%]). Also, the meta-analysis showed cough, headache, myalgia, nausea, diarrhea, and fatigue were 1.37 (CI 95%: 1.20-1.55), 1.23 (CI 95%: 1.09-1.38), 1.25 (CI 95%: 1.04-1.50), 1.19 (CI 95%: 1.02-1.40), 1.89 (CI 95%: 1.30-2.75), 1.49 (CI 95%: 1.07-2.09), and 1.14 (CI 95%: 0.98-1.33), respectively, whereas the risk of all these symptoms was higher in COVID-19 patients with chronic liver diseases than ones without chronic liver disorders. Conclusion The mortality and complications due to COVID-19 were significantly different between patients with the chronic liver disease and the general population.