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COVID-19 Pandemic–Related Disruptions in Routine Cirrhosis Care and Associated Clinical Outcomes among San Francisco Bay Area Veterans

Year: 2025

Type: article

Abstract: Background and Aims: The COVID-19 pandemic disrupted health-care delivery for chronic conditions managed in specialty care and particularly among socioeconomically disadvantaged and Veteran populations. Clinical outcomes in cirrhosis are highly dependent on routine care, including clinic visits, labs, and imaging. This study examines the pandemic's impact on adherence to cirrhosis-related quality indicators and clinical outcomes among Bay Area Veterans receiving hepatology care. Methods: We conducted a retrospective cohort study of Veterans with cirrhosis seen at San Francisco and Palo Alto Veterans Affairs hepatology clinics (March 2017-March 2023). Adherence to quality indicators-hepatocellular carcinoma (HCC) screening, lab monitoring, and hepatology visits-was compared between prepandemic (2017-2020) and pandemic-postpandemic (2020-2023) periods. Multivariable logistic regression assessed the effect of time and pandemic phase on clinical outcomes, including new hepatic decompensation, new HCC, and liver-related hospitalizations or death. Results: < .001). Conclusion: The pandemic significantly disrupted cirrhosis care among Bay Area Veterans, potentially resulting in "health debt" that may affect outcomes in coming years. Targeted interventions should re-engage patients, addressing these care gaps and improving clinical outcomes.

Source: Gastro Hep Advances

DOI: 10.1016/j.gastha.2025.100711