{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:47:47Z","timestamp":1780919267412,"version":"3.54.1"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The COVID-19 pandemic profoundly disrupted global healthcare systems, limiting access to diagnostic and therapeutic services for chronic diseases. Patients with decompensated liver cirrhosis were particularly vulnerable due to their fragile clinical status and dependence on continuous medical care. This study aimed to evaluate the temporal evolution of clinical, biological, and prognostic parameters in patients admitted emergently with decompensated liver cirrhosis across three distinct phases: pre-pandemic, pandemic, and post-pandemic. Materials and Methods: A retrospective, single-center study was conducted at the Department of Gastroenterology, Municipal Clinical Emergency Hospital, Timi\u0219oara, Romania, including 355 patients hospitalized between February 2018 and February 2024. Clinical, biochemical, and outcome data were collected and analyzed using univariate and multivariate logistic regression models to identify independent predictors of in-hospital mortality for each study period. Results: Significant temporal variations were observed in disease severity, management, and outcomes. The mean MELD score increased from 18.7 to 21.0 during the pandemic (p = 0.043), while endoscopic evaluations declined markedly (59.4% pre-pandemic vs. 42.7% pandemic, p = 0.037). Mortality rose from 21.7% to 30.2% during the pandemic (p = 0.044) and remained elevated post-pandemic (26.4%). Multivariate regression identified Child\u2013Pugh, MELD, and Baveno scores as consistent mortality predictors, though their relative weight varied by period. During the pandemic, acute complications\u2014particularly jaundice (OR = 294) and upper gastrointestinal bleeding (OR = 355)\u2014became dominant determinants of death. Conclusions: The pandemic transformed cirrhosis from a chronic, manageable disease into an acutely unstable condition, primarily due to delayed presentation and restricted procedural access. Although post-pandemic recovery was evident, residual increases in mortality and severity indicate lasting effects of healthcare disruption, underscoring the need to strengthen system resilience and continuity of care for patients with chronic liver disease.<\/jats:p>","DOI":"10.3390\/medicina62020404","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T08:50:03Z","timestamp":1771577403000},"page":"404","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the Long-Term Impact of the COVID-19 Pandemic on Hospital Outcomes in Patients with Decompensated Liver Cirrhosis"],"prefix":"10.3390","volume":"62","author":[{"given":"Melania Veronica","family":"Ardelean","sequence":"first","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu Florin","family":"Ardelean","sequence":"additional","affiliation":[{"name":"Department IX, II Discipline of Surgical Semiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-6584","authenticated-orcid":false,"given":"Dana Roxana","family":"Buzas","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Ciubotaru","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-4178","authenticated-orcid":false,"given":"Vlad","family":"Ivan","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8462-9062","authenticated-orcid":false,"given":"Alin Viorel","family":"Istodor","sequence":"additional","affiliation":[{"name":"I Department of Surgery, I Discipline of Surgical Semiology and Thoracic Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center Hepatobiliary Pancreatic Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Florin","family":"Lighezan","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"},{"name":"Center of Advanced Research in Cardiology and Hemostasology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norina Simona","family":"Basa","sequence":"additional","affiliation":[{"name":"Department V, Internal Medicine I Discipline of Medical Semiology I, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1016\/j.cgh.2019.07.060","article-title":"Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis","volume":"18","author":"Moon","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.jhep.2023.03.017","article-title":"Global burden of liver disease: 2023 update","volume":"79","author":"Devarbhavi","year":"2023","journal-title":"J. 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