{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:43:22Z","timestamp":1786977802048,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>\n                    The coronavirus disease 2019 (COVID\u201019) pandemic necessitated down\u2010scaling of in\u2010hospital care to prohibit the spread of severe acute respiratory syndrome\u2013coronavirus\u20102. We (1) assessed patient perceptions on quality of care by telesurvey (cohort 1) and written questionnaire (cohort 2), and (2) analyzed trends in elective and nonelective admissions before (December 2019 to February 2020) and during (March to May 2020) the COVID\u201019 pandemic in Austria. A total of 279 outpatients were recruited into cohort 1 and 138 patients into cohort 2. All admissions from December 2019 to May 2020 to the Division of Gastroenterology\/Hepatology at the Vienna General Hospital were analyzed. A total of 32.6% (n\u00a0=\u00a091 of 279) of cohort 1 and 72.5% (n\u00a0=\u00a095 of 131) of cohort 2 had telemedical contact, whereas 59.5% (n\u00a0=\u00a0166 of 279) and 68.2% (n\u00a0=\u00a090 of 132) had face\u2010to\u2010face visits. A total of 24.1% (n\u00a0=\u00a032 of 133) needed acute medical help during health care restrictions; however, 57.3% (n\u00a0=\u00a051 of 89) reported that contacting their physician during COVID\u201019 was difficult or impossible. Patient\u2010reported satisfaction with treatment decreased significantly during restrictions in cohort 1 (visual analog scale [VAS] 0\u201010: 9.0\u00a0\u00b1\u00a01.6 to 8.6\u00a0\u00b1\u00a02.2;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0&lt;\u00a00.001) and insignificantly in cohort 2 (VAS 0\u201010: 8.9\u00a0\u00b1\u00a01.6 to 8.7\u00a0\u00b1\u00a02.1;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.182). Despite fewer hospital admissions during COVID\u201019, the proportion of nonelective admissions (+6.3%) and intensive care unit admissions (+6.7%) increased. Patients with cirrhosis with nonelective admissions during COVID\u201019 had significantly higher Model for End\u2010Stage Liver Disease (MELD) (25.5 [14.2] vs. 17.0 [interquartile range: 8.8];\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.003) and \u0394MELD (difference from last MELD: 3.9\u00a0\u00b1\u00a06.3 vs. 8.7\u00a0\u00b1\u00a06.4;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.008), required immediate intensive care more frequently (26.7% vs. 5.6%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.034), and had significantly increased 30\u2010day liver\u2010related mortality (30.0% vs. 8.3%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u00a0=\u00a00.028).\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    The COVID\u201019 pandemic\u2019s effects on quality of liver care is evident from decreased patient satisfaction, hospitalization of sicker patients with advanced chronic liver disease, and increased liver\u2010related mortality. Strategies for improved telemedical liver care and preemptive treatment of cirrhosis\u2010related complications are needed to counteract the COVID\u201019\u2010associated restrictions of in\u2010hospital care.\n                  <\/jats:p>","DOI":"10.1002\/hep4.1758","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T10:41:21Z","timestamp":1621334481000},"page":"1660-1675","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":27,"title":["COVID\u201019\u2010Related Downscaling of In\u2010Hospital Liver Care Decreased Patient Satisfaction and Increased Liver\u2010Related Mortality"],"prefix":"10.1097","volume":"5","author":[{"given":"Lukas","family":"Hartl","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-166X","authenticated-orcid":false,"given":"Georg","family":"Semmler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-3372","authenticated-orcid":false,"given":"Benedikt Silvester","family":"Hofer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Lab for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawa","family":"Schirwani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Jachs","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Lab for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-8518","authenticated-orcid":false,"given":"David Josef Maria","family":"Bauer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Binter","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Pomej","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-532X","authenticated-orcid":false,"given":"Matthias","family":"Pinter","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-0017","authenticated-orcid":false,"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"},{"name":"Christian Doppler Lab for Portal Hypertension and Liver Fibrosis,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-5133","authenticated-orcid":false,"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Lab,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"key":"hep41758-bib-0001-20241015","doi-asserted-by":"crossref","first-page":"105951","DOI":"10.1016\/j.ijantimicag.2020.105951","article-title":"Coronavirus disease 2019 (COVID\u201019): current status and future perspectives","volume":"55","year":"2020","journal-title":"Int J Antimicrob 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