Impact of the COVID-19 pandemic on the incidence and type of infections in hospitalized patients with cirrhosis

comorbid illnesses, cirrhosis etiology, and cirrhosis complications (all defined by ICD-10-CM codes).Results: The cohort included 71, 552 veterans with cirrhosis, who were mostly men (96.2%) with a with median age of 65.7 years (IQR 61-70).Ten percent (n = 7, 295) of the overall cohort had a diagnosis code of dementia overall, which increased to 12.4% among patients ≥65 years.Dementia was significantly associated with age (adjusted odds ratio and 95% confidence interval, AOR white race (1.09[1.01,1.16]),urban residence (1.19[1.11,1.27]), alcohol-related cirrhosis (1.30[1.18-1.44]),hepatitis B (1.39[1.18-1.62]),alcohol use disorder (1.42[1.29-1.6]),cerebral vascular disease, peripheral vascular disease, diabetes, chronic kidney disease, and chronic heart failure, and negatively associated with MELD-Na (0.95 [0.92-0.95]/5points) in multivariate logistic regression (Figures 1A and 1B).Dementia was significantly positively associated with HE (2.87[2.68-3.08]),but negatively associated with other cirrhosis complications in these models.Conclusion: Diagnostic codes for dementia were found in 10% of Veterans with cirrhosis and most strongly associated with HE, but not other complications of cirrhosis.Furthermore, alcohol use disorder along with cardiovascular risk factors were associated with dementia, but not NASH itself.Further research is needed to determine strategies to differentiate between HE and dementia and manage this population with specific needs to prevent burden on families, patients and VHA system.