Carr, Rotonya M
Mayo Clinic
Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, Washington, USA.
Citations 2
Pragmatic strategies to address health disparities along the continuum of care in chronic liver disease
Brahmania, Mayur , Rogal, Shari S. , Serper, Marina , Goldberg, David S. , Mathur, Amit K. , Wilder, Julius , Vittorio, Jennifer , Yeoman, Andrew D. , Lazo, Mariana , Kardashian, Ani , Verma, Manisha , Verna, Elizabeth C. , Simpson, Dinee C. , Rosenblatt, Russell , McElroy, Lisa M. , Wadwhani, Sharad I., Strauss, Alexandra T. , Aiza, Ignacio , Carr, Rotonya M. , Yang, Jin Mo , Brady, Carla W. , Fortune, Brett E. , Rogal, Shari , Patel, Arpan , Goldberg, David , Mathur, Amit , Wilder, Julius , Vittorio, Jennifer M , Yeoman, Andrew , Lazo, Mariana , Kardashian, Ani , Asrani, Sumeet K , Spann, Ashley , Ufere, Nneka N , Verma, Manisha , Verna, Elizabeth C , Simpson, Dinee , Schold, Jesse D , Rosenblatt, Russell , McElroy, Lisa M , Wadhwani, Sharad I , Lee, Tzu-Hao , Strauss, Alexandra T , Aiza, Ignacio , Carr, Rotonya M , Yang, Jin Mo , Brady, Carla , Serper, Marina , Patel, Arpan , Rich, Nicole E. , Asrani, Sumeet K. , Spann, Ashley , Lee, Tzu‐Hao , Chung, Raymond T.
Hepatology Communications | May 2, 2024 | Volume: 8 | Issue: 5 | Pages: No page available
Racial, ethnic, and socioeconomic disparities exist in the prevalence and natural history of chronic liver disease, access to care, and clinical outcomes. Solutions to improve health equity range widely, from digital health tools to policy changes. The current review outlines the disparities along the chronic liver disease health care continuum from screening and diagnosis to the management of cirrhosis and considerations of pre-liver and post-liver transplantation. Using a health equity research and implementation science framework, we offer pragmatic strategies to address barriers to implementing high-quality equitable care for patients with chronic liver disease.
Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study
Aby, Elizabeth S. , Moafa, Ghady, Sultan, Mohammad T., Cacioppo, Paula A., Kumar, Sonal , Chung, Raymond , Bloom, Patricia P. , Gustafson, Jenna , Daidone, Michael , Reinus, Zoe, Debes, José D. , Sandhu, Sunny , Khalid, Sameeha , Roytman, Marina , Catana, Andreea M. , Wegermann, Kara , Carr, Rotonya M. , Saiman, Yedidya , Kassab, Ihab , Chen, Vincent , Rabiee, Atoosa , Rosenberg, C. E., Nguyen, Veronica , Gainey, Christina S. , Chavin, Kenneth D. , Chascsa, David M. , Varelas, Lee , Moghe, Akshata , Dhanasekaran, Renumathy , Latt, Nyan , Bloom, Patricia P , Debes, Jose D , Sandhu, Sunny , Sohal, Aalam , Khalid, Sameeha , Roytman, Marina , Catana, Andreea Maria , Wegermann, Kara , Carr, Rotonya M , Chen, V L , Rabiee, Atoosa , Nguyen, Veronica , Gainey, Christina , Zhou, Kali , Chavin, Kenneth , Lizaola-Mayo, Blanca , Chascsa, David M , Varelas, Lee , Dhanasekaran, Renumathy , Lizaola‐Mayo, Blanca
Hepatology Communications | January 24, 2023 | Volume: 7 | Issue: 1 | Pages: e8874-e8874
10.1097/01.hc9.0000897224.68874.de
Background: COVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited. Methods: We conducted a multicenter, observational cohort study of adult patients with CLD who were diagnosed with COVID-19 before May 30, 2020, to determine long-term clinical outcomes. We used a control group of patients with CLD confirmed negative for COVID-19. Results: We followed 666 patients with CLD (median age 58 years, 52.8% male) for a median of 384 (interquartile range: 31–462) days. The long-term mortality was 8.1%; with 3.6% experiencing delayed COVID-19-related mortality. Compared to a propensity-matched control group of patients with CLD without COVID-19 (n=1332), patients with CLD with COVID-19 had worse long-term survival [p<0.001; hazards ratio (HR): 1.69; 95% CI: 1.19–2.41] and higher rate of hospitalization (p<0.001, HR: 2.00, 1.62–2.48) over a 1-year follow-up period. Overall, 29.9% of patients reported symptoms of long-COVID-19. On multivariable analysis, female sex (p=0.05, HR: 2.45, 1.01–2.11), Hispanic ethnicity (p=0.003, HR: 1.94, 1.26–2.99), and severe COVID-19 requiring mechanical ventilation (p=0.028, HR: 1.74, 1.06–2.86) predicted long-COVID-19. In survivors, liver-related laboratory parameters showed significant improvement after COVID-19 resolution. COVID-19 vaccine status was available for 72% (n=470) of patients with CLD and history of COVID-19, of whom, 70% (n=326) had received the COVID-19 vaccine. Conclusions: Our large, longitudinal, multicenter study demonstrates a high burden of long-term mortality and morbidity in patients with CLD and COVID-19. Symptoms consistent with long-COVID-19 were present in 30% of patients with CLD. These results illustrate the prolonged implications of COVID-19 both for recovering patients and for health care systems.