Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multi-center Study.
Identifieur interne : 000381 ( Main/Exploration ); précédent : 000380; suivant : 000382Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multi-center Study.
Auteurs : Donghee Kim [États-Unis] ; Nia Adeniji [États-Unis] ; Nyann Latt [États-Unis] ; Sonal Kumar [États-Unis] ; Patricia P. Bloom [États-Unis] ; Elizabeth S. Aby [États-Unis] ; Ponni Perumalswami [États-Unis] ; Marina Roytman [États-Unis] ; Michael Li [États-Unis] ; Alexander S. Vogel [États-Unis] ; Andreea M. Catana [États-Unis] ; Kara Wegermann [États-Unis] ; Rotonya M. Carr [États-Unis] ; Costica Aloman [États-Unis] ; Vincent Chen [États-Unis] ; Atoosa Rabiee [États-Unis] ; Brett Sadowski [États-Unis] ; Veronica Nguyen [États-Unis] ; Winston Dunn [États-Unis] ; Kenneth Chavin [États-Unis] ; Kali Zhou [États-Unis] ; Blanca Lizaola-Mayo [États-Unis] ; Akshata Moghe [États-Unis] ; José Debes [États-Unis] ; Tzu-Hao Lee [États-Unis] ; Andrea Branch [États-Unis] ; Kathleen Viveiros [États-Unis] ; Walter Chan [États-Unis] ; David Chascsa [États-Unis] ; Paul Kwo [États-Unis] ; Renumathy Dhanasekaran [États-Unis]Source :
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [ 1542-7714 ] ; 2020.
Abstract
BACKGROUND & AIMS
Chronic liver disease (CLD) represents a major global health burden. We undertook this study to identify the factors associated with adverse outcomes in patients with CLD who acquire the novel coronavirus-2019 (COVID-19).
METHODS
We conducted a multi-center, observational cohort study across 21 institutions in the United States (US) of adult patients with CLD and laboratory-confirmed diagnosis of COVID-19 between March 1, 2020 and May 30, 2020. We performed survival analysis to identify independent predictors of all-cause mortality and COVID-19 related mortality, and multivariate logistic regression to determine the risk of severe COVID-19 in patients with CLD.
RESULTS
Of the 978 patients in our cohort, 867 patients (mean age 56.9±14.5 years, 55% male) met inclusion criteria. The overall all-cause mortality was 14.0% (n = 121), and 61.7% (n = 535) had severe COVID-19. Patients presenting with diarrhea or nausea/vomiting were more likely to have severe COVID-19. The liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.29-4.55), decompensated cirrhosis (HR 2.91 [1.70-5.00]) and hepatocellular carcinoma (HCC) (HR 3.31 [1.53-7.16]). Other factors were increasing age, diabetes, hypertension, chronic obstructive pulmonary disease and current smoker. Hispanic ethnicity (odds ratio [OR] 2.33 [1.47-3.70]) and decompensated cirrhosis (OR 2.50 [1.20-5.21]) were independently associated with risk for severe COVID-19.
CONCLUSIONS
The risk factors which predict higher overall mortality among patients with CLD and COVID-19 are ALD, decompensated cirrhosis and HCC. Hispanic ethnicity and decompensated cirrhosis are associated with severe COVID-19. Our results will enable risk stratification and personalization of the management of patients with CLD and COVID-19. Clinicaltrials.gov number NCT04439084.
DOI: 10.1016/j.cgh.2020.09.027
PubMed: 32950749
PubMed Central: PMC7497795
Affiliations:
- États-Unis
- Arizona, Californie, Caroline du Nord, District de Columbia, Illinois, Kansas, Louisiane, Massachusetts, Michigan, Minnesota, Ohio, Pennsylvanie, État de New York
Links toward previous steps (curation, corpus...)
Le document en format XML
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Michigan.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>University of Michigan, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Rabiee, Atoosa" sort="Rabiee, Atoosa" uniqKey="Rabiee A" first="Atoosa" last="Rabiee">Atoosa Rabiee</name><affiliation wicri:level="2"><nlm:affiliation>VA Medical Center, Washington, District of Columbia.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>VA Medical Center, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Sadowski, Brett" sort="Sadowski, Brett" uniqKey="Sadowski B" first="Brett" last="Sadowski">Brett Sadowski</name><affiliation wicri:level="2"><nlm:affiliation>Georgetown University, Washington, District of Columbia.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>Georgetown University, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Nguyen, Veronica" sort="Nguyen, Veronica" uniqKey="Nguyen V" first="Veronica" last="Nguyen">Veronica Nguyen</name><affiliation wicri:level="2"><nlm:affiliation>University of Arizona/BannerHealth, Tucson, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>University of Arizona/BannerHealth, Tucson</wicri:cityArea></affiliation></author><author><name sortKey="Dunn, Winston" sort="Dunn, Winston" uniqKey="Dunn W" first="Winston" last="Dunn">Winston Dunn</name><affiliation wicri:level="2"><nlm:affiliation>University of Kansas Medical Center, Kansas City, Kansas.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Kansas</region></placeName><wicri:cityArea>University of Kansas Medical Center, Kansas City</wicri:cityArea></affiliation></author><author><name sortKey="Chavin, Kenneth" sort="Chavin, Kenneth" uniqKey="Chavin K" first="Kenneth" last="Chavin">Kenneth Chavin</name><affiliation wicri:level="2"><nlm:affiliation>University Hospitals Cleveland Medical Center, Cleveland, Ohio.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>University Hospitals Cleveland Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Zhou, Kali" sort="Zhou, Kali" uniqKey="Zhou K" first="Kali" last="Zhou">Kali Zhou</name><affiliation wicri:level="2"><nlm:affiliation>University of Southern California, Los Angeles, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of Southern California, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Lizaola Mayo, Blanca" sort="Lizaola Mayo, Blanca" uniqKey="Lizaola Mayo B" first="Blanca" last="Lizaola-Mayo">Blanca Lizaola-Mayo</name><affiliation wicri:level="2"><nlm:affiliation>Mayo Clinic, Scottsdale, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Moghe, Akshata" sort="Moghe, Akshata" uniqKey="Moghe A" first="Akshata" last="Moghe">Akshata Moghe</name><affiliation wicri:level="2"><nlm:affiliation>University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Debes, Jose" sort="Debes, Jose" uniqKey="Debes J" first="José" last="Debes">José Debes</name><affiliation wicri:level="2"><nlm:affiliation>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Lee, Tzu Hao" sort="Lee, Tzu Hao" uniqKey="Lee T" first="Tzu-Hao" last="Lee">Tzu-Hao Lee</name><affiliation wicri:level="2"><nlm:affiliation>Duke University, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke University, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Branch, Andrea" sort="Branch, Andrea" uniqKey="Branch A" first="Andrea" last="Branch">Andrea Branch</name><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Icahn School of Medicine at Mount Sinai, New York</wicri:cityArea></affiliation></author><author><name sortKey="Viveiros, Kathleen" sort="Viveiros, Kathleen" uniqKey="Viveiros K" first="Kathleen" last="Viveiros">Kathleen Viveiros</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Chan, Walter" sort="Chan, Walter" uniqKey="Chan W" first="Walter" last="Chan">Walter Chan</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Chascsa, David" sort="Chascsa, David" uniqKey="Chascsa D" first="David" last="Chascsa">David Chascsa</name><affiliation wicri:level="2"><nlm:affiliation>Mayo Clinic, Scottsdale, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Kwo, Paul" sort="Kwo, Paul" uniqKey="Kwo P" first="Paul" last="Kwo">Paul Kwo</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Dhanasekaran, Renumathy" sort="Dhanasekaran, Renumathy" uniqKey="Dhanasekaran R" first="Renumathy" last="Dhanasekaran">Renumathy Dhanasekaran</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California. Electronic address: dhanaser@stanford.edu.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32950749</idno><idno type="pmid">32950749</idno><idno type="doi">10.1016/j.cgh.2020.09.027</idno><idno type="pmc">PMC7497795</idno><idno type="wicri:Area/Main/Corpus">000305</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000305</idno><idno type="wicri:Area/Main/Curation">000305</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000305</idno><idno type="wicri:Area/Main/Exploration">000305</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multi-center Study.</title><author><name sortKey="Kim, Donghee" sort="Kim, Donghee" uniqKey="Kim D" first="Donghee" last="Kim">Donghee Kim</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Adeniji, Nia" sort="Adeniji, Nia" uniqKey="Adeniji N" first="Nia" last="Adeniji">Nia Adeniji</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Latt, Nyann" sort="Latt, Nyann" uniqKey="Latt N" first="Nyann" last="Latt">Nyann Latt</name><affiliation wicri:level="2"><nlm:affiliation>Ochsner Medical Center, New Orleans, Louisiana.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Louisiane</region></placeName><wicri:cityArea>Ochsner Medical Center, New Orleans</wicri:cityArea></affiliation></author><author><name sortKey="Kumar, Sonal" sort="Kumar, Sonal" uniqKey="Kumar S" first="Sonal" last="Kumar">Sonal Kumar</name><affiliation wicri:level="2"><nlm:affiliation>Weill Cornell Medicine, New York, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Weill Cornell Medicine, New York</wicri:cityArea></affiliation></author><author><name sortKey="Bloom, Patricia P" sort="Bloom, Patricia P" uniqKey="Bloom P" first="Patricia P" last="Bloom">Patricia P. Bloom</name><affiliation wicri:level="2"><nlm:affiliation>Massachusetts General Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Massachusetts General Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Aby, Elizabeth S" sort="Aby, Elizabeth S" uniqKey="Aby E" first="Elizabeth S" last="Aby">Elizabeth S. Aby</name><affiliation wicri:level="2"><nlm:affiliation>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Perumalswami, Ponni" sort="Perumalswami, Ponni" uniqKey="Perumalswami P" first="Ponni" last="Perumalswami">Ponni Perumalswami</name><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Icahn School of Medicine at Mount Sinai, New York</wicri:cityArea></affiliation></author><author><name sortKey="Roytman, Marina" sort="Roytman, Marina" uniqKey="Roytman M" first="Marina" last="Roytman">Marina Roytman</name><affiliation wicri:level="2"><nlm:affiliation>University of California San Francisco, Fresno, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of California San Francisco, Fresno</wicri:cityArea></affiliation></author><author><name sortKey="Li, Michael" sort="Li, Michael" uniqKey="Li M" first="Michael" last="Li">Michael Li</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Vogel, Alexander S" sort="Vogel, Alexander S" uniqKey="Vogel A" first="Alexander S" last="Vogel">Alexander S. Vogel</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Catana, Andreea M" sort="Catana, Andreea M" uniqKey="Catana A" first="Andreea M" last="Catana">Andreea M. Catana</name><affiliation wicri:level="2"><nlm:affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Beth Israel Deaconess Medical Center, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Wegermann, Kara" sort="Wegermann, Kara" uniqKey="Wegermann K" first="Kara" last="Wegermann">Kara Wegermann</name><affiliation wicri:level="2"><nlm:affiliation>Duke University, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke University, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Carr, Rotonya M" sort="Carr, Rotonya M" uniqKey="Carr R" first="Rotonya M" last="Carr">Rotonya M. Carr</name><affiliation wicri:level="2"><nlm:affiliation>University of Pennsylvania, Philadelphia, Pennsylvania.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>University of Pennsylvania, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Aloman, Costica" sort="Aloman, Costica" uniqKey="Aloman C" first="Costica" last="Aloman">Costica Aloman</name><affiliation wicri:level="2"><nlm:affiliation>Rush University Medical Center, Chicago, Illinois.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>Rush University Medical Center, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Chen, Vincent" sort="Chen, Vincent" uniqKey="Chen V" first="Vincent" last="Chen">Vincent Chen</name><affiliation wicri:level="2"><nlm:affiliation>University of Michigan, Ann Arbor, Michigan.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Michigan</region></placeName><wicri:cityArea>University of Michigan, Ann Arbor</wicri:cityArea></affiliation></author><author><name sortKey="Rabiee, Atoosa" sort="Rabiee, Atoosa" uniqKey="Rabiee A" first="Atoosa" last="Rabiee">Atoosa Rabiee</name><affiliation wicri:level="2"><nlm:affiliation>VA Medical Center, Washington, District of Columbia.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>VA Medical Center, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Sadowski, Brett" sort="Sadowski, Brett" uniqKey="Sadowski B" first="Brett" last="Sadowski">Brett Sadowski</name><affiliation wicri:level="2"><nlm:affiliation>Georgetown University, Washington, District of Columbia.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">District de Columbia</region></placeName><wicri:cityArea>Georgetown University, Washington</wicri:cityArea></affiliation></author><author><name sortKey="Nguyen, Veronica" sort="Nguyen, Veronica" uniqKey="Nguyen V" first="Veronica" last="Nguyen">Veronica Nguyen</name><affiliation wicri:level="2"><nlm:affiliation>University of Arizona/BannerHealth, Tucson, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>University of Arizona/BannerHealth, Tucson</wicri:cityArea></affiliation></author><author><name sortKey="Dunn, Winston" sort="Dunn, Winston" uniqKey="Dunn W" first="Winston" last="Dunn">Winston Dunn</name><affiliation wicri:level="2"><nlm:affiliation>University of Kansas Medical Center, Kansas City, Kansas.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Kansas</region></placeName><wicri:cityArea>University of Kansas Medical Center, Kansas City</wicri:cityArea></affiliation></author><author><name sortKey="Chavin, Kenneth" sort="Chavin, Kenneth" uniqKey="Chavin K" first="Kenneth" last="Chavin">Kenneth Chavin</name><affiliation wicri:level="2"><nlm:affiliation>University Hospitals Cleveland Medical Center, Cleveland, Ohio.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>University Hospitals Cleveland Medical Center, Cleveland</wicri:cityArea></affiliation></author><author><name sortKey="Zhou, Kali" sort="Zhou, Kali" uniqKey="Zhou K" first="Kali" last="Zhou">Kali Zhou</name><affiliation wicri:level="2"><nlm:affiliation>University of Southern California, Los Angeles, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>University of Southern California, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Lizaola Mayo, Blanca" sort="Lizaola Mayo, Blanca" uniqKey="Lizaola Mayo B" first="Blanca" last="Lizaola-Mayo">Blanca Lizaola-Mayo</name><affiliation wicri:level="2"><nlm:affiliation>Mayo Clinic, Scottsdale, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Moghe, Akshata" sort="Moghe, Akshata" uniqKey="Moghe A" first="Akshata" last="Moghe">Akshata Moghe</name><affiliation wicri:level="2"><nlm:affiliation>University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Debes, Jose" sort="Debes, Jose" uniqKey="Debes J" first="José" last="Debes">José Debes</name><affiliation wicri:level="2"><nlm:affiliation>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Minnesota</region></placeName><wicri:cityArea>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis</wicri:cityArea></affiliation></author><author><name sortKey="Lee, Tzu Hao" sort="Lee, Tzu Hao" uniqKey="Lee T" first="Tzu-Hao" last="Lee">Tzu-Hao Lee</name><affiliation wicri:level="2"><nlm:affiliation>Duke University, Durham, North Carolina.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName><wicri:cityArea>Duke University, Durham</wicri:cityArea></affiliation></author><author><name sortKey="Branch, Andrea" sort="Branch, Andrea" uniqKey="Branch A" first="Andrea" last="Branch">Andrea Branch</name><affiliation wicri:level="2"><nlm:affiliation>Icahn School of Medicine at Mount Sinai, New York, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Icahn School of Medicine at Mount Sinai, New York</wicri:cityArea></affiliation></author><author><name sortKey="Viveiros, Kathleen" sort="Viveiros, Kathleen" uniqKey="Viveiros K" first="Kathleen" last="Viveiros">Kathleen Viveiros</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Chan, Walter" sort="Chan, Walter" uniqKey="Chan W" first="Walter" last="Chan">Walter Chan</name><affiliation wicri:level="2"><nlm:affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Brigham and Women's Hospital, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Chascsa, David" sort="Chascsa, David" uniqKey="Chascsa D" first="David" last="Chascsa">David Chascsa</name><affiliation wicri:level="2"><nlm:affiliation>Mayo Clinic, Scottsdale, Arizona.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Kwo, Paul" sort="Kwo, Paul" uniqKey="Kwo P" first="Paul" last="Kwo">Paul Kwo</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author><author><name sortKey="Dhanasekaran, Renumathy" sort="Dhanasekaran, Renumathy" uniqKey="Dhanasekaran R" first="Renumathy" last="Dhanasekaran">Renumathy Dhanasekaran</name><affiliation wicri:level="2"><nlm:affiliation>Stanford University, Stanford, California. Electronic address: dhanaser@stanford.edu.</nlm:affiliation><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Stanford University, Stanford</wicri:cityArea></affiliation></author></analytic><series><title level="j">Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association</title><idno type="eISSN">1542-7714</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND & AIMS</b></p><p>Chronic liver disease (CLD) represents a major global health burden. We undertook this study to identify the factors associated with adverse outcomes in patients with CLD who acquire the novel coronavirus-2019 (COVID-19).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a multi-center, observational cohort study across 21 institutions in the United States (US) of adult patients with CLD and laboratory-confirmed diagnosis of COVID-19 between March 1, 2020 and May 30, 2020. We performed survival analysis to identify independent predictors of all-cause mortality and COVID-19 related mortality, and multivariate logistic regression to determine the risk of severe COVID-19 in patients with CLD.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of the 978 patients in our cohort, 867 patients (mean age 56.9±14.5 years, 55% male) met inclusion criteria. The overall all-cause mortality was 14.0% (n = 121), and 61.7% (n = 535) had severe COVID-19. Patients presenting with diarrhea or nausea/vomiting were more likely to have severe COVID-19. The liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.29-4.55), decompensated cirrhosis (HR 2.91 [1.70-5.00]) and hepatocellular carcinoma (HCC) (HR 3.31 [1.53-7.16]). Other factors were increasing age, diabetes, hypertension, chronic obstructive pulmonary disease and current smoker. Hispanic ethnicity (odds ratio [OR] 2.33 [1.47-3.70]) and decompensated cirrhosis (OR 2.50 [1.20-5.21]) were independently associated with risk for severe COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The risk factors which predict higher overall mortality among patients with CLD and COVID-19 are ALD, decompensated cirrhosis and HCC. Hispanic ethnicity and decompensated cirrhosis are associated with severe COVID-19. Our results will enable risk stratification and personalization of the management of patients with CLD and COVID-19. Clinicaltrials.gov number NCT04439084.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32950749</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1542-7714</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Sep</Month><Day>17</Day></PubDate></JournalIssue><Title>Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association</Title><ISOAbbreviation>Clin Gastroenterol Hepatol</ISOAbbreviation></Journal><ArticleTitle>Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multi-center Study.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S1542-3565(20)31288-X</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.cgh.2020.09.027</ELocationID><Abstract><AbstractText Label="BACKGROUND & AIMS" NlmCategory="OBJECTIVE">Chronic liver disease (CLD) represents a major global health burden. We undertook this study to identify the factors associated with adverse outcomes in patients with CLD who acquire the novel coronavirus-2019 (COVID-19).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a multi-center, observational cohort study across 21 institutions in the United States (US) of adult patients with CLD and laboratory-confirmed diagnosis of COVID-19 between March 1, 2020 and May 30, 2020. We performed survival analysis to identify independent predictors of all-cause mortality and COVID-19 related mortality, and multivariate logistic regression to determine the risk of severe COVID-19 in patients with CLD.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Of the 978 patients in our cohort, 867 patients (mean age 56.9±14.5 years, 55% male) met inclusion criteria. The overall all-cause mortality was 14.0% (n = 121), and 61.7% (n = 535) had severe COVID-19. Patients presenting with diarrhea or nausea/vomiting were more likely to have severe COVID-19. The liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.29-4.55), decompensated cirrhosis (HR 2.91 [1.70-5.00]) and hepatocellular carcinoma (HCC) (HR 3.31 [1.53-7.16]). Other factors were increasing age, diabetes, hypertension, chronic obstructive pulmonary disease and current smoker. Hispanic ethnicity (odds ratio [OR] 2.33 [1.47-3.70]) and decompensated cirrhosis (OR 2.50 [1.20-5.21]) were independently associated with risk for severe COVID-19.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The risk factors which predict higher overall mortality among patients with CLD and COVID-19 are ALD, decompensated cirrhosis and HCC. Hispanic ethnicity and decompensated cirrhosis are associated with severe COVID-19. Our results will enable risk stratification and personalization of the management of patients with CLD and COVID-19. Clinicaltrials.gov number NCT04439084.</AbstractText><CopyrightInformation>Copyright © 2020 AGA Institute. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Donghee</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Stanford University, Stanford, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Adeniji</LastName><ForeName>Nia</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Stanford University, Stanford, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Latt</LastName><ForeName>Nyann</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Ochsner Medical Center, New Orleans, Louisiana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kumar</LastName><ForeName>Sonal</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Weill Cornell Medicine, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bloom</LastName><ForeName>Patricia P</ForeName><Initials>PP</Initials><AffiliationInfo><Affiliation>Massachusetts General Hospital, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aby</LastName><ForeName>Elizabeth S</ForeName><Initials>ES</Initials><AffiliationInfo><Affiliation>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Perumalswami</LastName><ForeName>Ponni</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Icahn School of Medicine at Mount Sinai, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roytman</LastName><ForeName>Marina</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>University of California San Francisco, Fresno, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Li</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vogel</LastName><ForeName>Alexander S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Catana</LastName><ForeName>Andreea M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wegermann</LastName><ForeName>Kara</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Duke University, Durham, North Carolina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Carr</LastName><ForeName>Rotonya M</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>University of Pennsylvania, Philadelphia, Pennsylvania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aloman</LastName><ForeName>Costica</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Rush University Medical Center, Chicago, Illinois.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>Vincent</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>University of Michigan, Ann Arbor, Michigan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rabiee</LastName><ForeName>Atoosa</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>VA Medical Center, Washington, District of Columbia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sadowski</LastName><ForeName>Brett</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Georgetown University, Washington, District of Columbia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nguyen</LastName><ForeName>Veronica</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>University of Arizona/BannerHealth, Tucson, Arizona.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dunn</LastName><ForeName>Winston</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>University of Kansas Medical Center, Kansas City, Kansas.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chavin</LastName><ForeName>Kenneth</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>University Hospitals Cleveland Medical Center, Cleveland, Ohio.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhou</LastName><ForeName>Kali</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>University of Southern California, Los Angeles, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lizaola-Mayo</LastName><ForeName>Blanca</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Mayo Clinic, Scottsdale, Arizona.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Moghe</LastName><ForeName>Akshata</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Debes</LastName><ForeName>José</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hennepin County Medical Center, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Tzu-Hao</ForeName><Initials>TH</Initials><AffiliationInfo><Affiliation>Duke University, Durham, North Carolina.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Branch</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Icahn School of Medicine at Mount Sinai, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Viveiros</LastName><ForeName>Kathleen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chan</LastName><ForeName>Walter</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Brigham and Women's Hospital, Boston, Massachusetts.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chascsa</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Mayo Clinic, Scottsdale, Arizona.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kwo</LastName><ForeName>Paul</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Stanford University, Stanford, California.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dhanasekaran</LastName><ForeName>Renumathy</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Stanford University, Stanford, California. Electronic address: dhanaser@stanford.edu.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT04439084</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>17</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Gastroenterol Hepatol</MedlineTA><NlmUniqueID>101160775</NlmUniqueID><ISSNLinking>1542-3565</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Alcohol</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Cirrhosis</Keyword><Keyword MajorTopicYN="N">Mortality</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>08</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>09</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>20</Day><Hour>20</Hour><Minute>28</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32950749</ArticleId><ArticleId IdType="pii">S1542-3565(20)31288-X</ArticleId><ArticleId 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IdType="pubmed">32239220</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Arizona</li><li>Californie</li><li>Caroline du Nord</li><li>District de Columbia</li><li>Illinois</li><li>Kansas</li><li>Louisiane</li><li>Massachusetts</li><li>Michigan</li><li>Minnesota</li><li>Ohio</li><li>Pennsylvanie</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Kim, Donghee" sort="Kim, Donghee" uniqKey="Kim D" first="Donghee" last="Kim">Donghee Kim</name></region><name sortKey="Aby, Elizabeth S" sort="Aby, Elizabeth S" uniqKey="Aby E" first="Elizabeth S" last="Aby">Elizabeth S. Aby</name><name sortKey="Adeniji, Nia" sort="Adeniji, Nia" uniqKey="Adeniji N" first="Nia" last="Adeniji">Nia Adeniji</name><name sortKey="Aloman, Costica" sort="Aloman, Costica" uniqKey="Aloman C" first="Costica" last="Aloman">Costica Aloman</name><name sortKey="Bloom, Patricia P" sort="Bloom, Patricia P" uniqKey="Bloom P" first="Patricia P" last="Bloom">Patricia P. Bloom</name><name sortKey="Branch, Andrea" sort="Branch, Andrea" uniqKey="Branch A" first="Andrea" last="Branch">Andrea Branch</name><name sortKey="Carr, Rotonya M" sort="Carr, Rotonya M" uniqKey="Carr R" first="Rotonya M" last="Carr">Rotonya M. Carr</name><name sortKey="Catana, Andreea M" sort="Catana, Andreea M" uniqKey="Catana A" first="Andreea M" last="Catana">Andreea M. Catana</name><name sortKey="Chan, Walter" sort="Chan, Walter" uniqKey="Chan W" first="Walter" last="Chan">Walter Chan</name><name sortKey="Chascsa, David" sort="Chascsa, David" uniqKey="Chascsa D" first="David" last="Chascsa">David Chascsa</name><name sortKey="Chavin, Kenneth" sort="Chavin, Kenneth" uniqKey="Chavin K" first="Kenneth" last="Chavin">Kenneth Chavin</name><name sortKey="Chen, Vincent" sort="Chen, Vincent" uniqKey="Chen V" first="Vincent" last="Chen">Vincent Chen</name><name sortKey="Debes, Jose" sort="Debes, Jose" uniqKey="Debes J" first="José" last="Debes">José Debes</name><name sortKey="Dhanasekaran, Renumathy" sort="Dhanasekaran, Renumathy" uniqKey="Dhanasekaran R" first="Renumathy" last="Dhanasekaran">Renumathy Dhanasekaran</name><name sortKey="Dunn, Winston" sort="Dunn, Winston" uniqKey="Dunn W" first="Winston" last="Dunn">Winston Dunn</name><name sortKey="Kumar, Sonal" sort="Kumar, Sonal" uniqKey="Kumar S" first="Sonal" last="Kumar">Sonal Kumar</name><name sortKey="Kwo, Paul" sort="Kwo, Paul" uniqKey="Kwo P" first="Paul" last="Kwo">Paul Kwo</name><name sortKey="Latt, Nyann" sort="Latt, Nyann" uniqKey="Latt N" first="Nyann" last="Latt">Nyann Latt</name><name sortKey="Lee, Tzu Hao" sort="Lee, Tzu Hao" uniqKey="Lee T" first="Tzu-Hao" last="Lee">Tzu-Hao Lee</name><name sortKey="Li, Michael" sort="Li, Michael" uniqKey="Li M" first="Michael" last="Li">Michael Li</name><name sortKey="Lizaola Mayo, Blanca" sort="Lizaola Mayo, Blanca" uniqKey="Lizaola Mayo B" first="Blanca" last="Lizaola-Mayo">Blanca Lizaola-Mayo</name><name sortKey="Moghe, Akshata" sort="Moghe, Akshata" uniqKey="Moghe A" first="Akshata" last="Moghe">Akshata Moghe</name><name sortKey="Nguyen, Veronica" sort="Nguyen, Veronica" uniqKey="Nguyen V" first="Veronica" last="Nguyen">Veronica Nguyen</name><name sortKey="Perumalswami, Ponni" sort="Perumalswami, Ponni" uniqKey="Perumalswami P" first="Ponni" last="Perumalswami">Ponni Perumalswami</name><name sortKey="Rabiee, Atoosa" sort="Rabiee, Atoosa" uniqKey="Rabiee A" first="Atoosa" last="Rabiee">Atoosa Rabiee</name><name sortKey="Roytman, Marina" sort="Roytman, Marina" uniqKey="Roytman M" first="Marina" last="Roytman">Marina Roytman</name><name sortKey="Sadowski, Brett" sort="Sadowski, Brett" uniqKey="Sadowski B" first="Brett" last="Sadowski">Brett Sadowski</name><name sortKey="Viveiros, Kathleen" sort="Viveiros, Kathleen" uniqKey="Viveiros K" first="Kathleen" last="Viveiros">Kathleen Viveiros</name><name sortKey="Vogel, Alexander S" sort="Vogel, Alexander S" uniqKey="Vogel A" first="Alexander S" last="Vogel">Alexander S. Vogel</name><name sortKey="Wegermann, Kara" sort="Wegermann, Kara" uniqKey="Wegermann K" first="Kara" last="Wegermann">Kara Wegermann</name><name sortKey="Zhou, Kali" sort="Zhou, Kali" uniqKey="Zhou K" first="Kali" last="Zhou">Kali Zhou</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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