Background&Aims: The COVID-19 pandemic necessitated down-scaling of in-hospital care to prohibit the spread of severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2). We (i)assessed patient perceptions on quality of care by tele-survey(cohort 1) and written questionnaire(cohort 2) and (ii)analyzed trends in elective and non-elective admissions prior to (12/2019-02/2020) and during (03/2020-05/2020) the COVID-19 pandemic in Austria. Methods: Two-hundred seventy-nine outpatients were recruited into cohort 1 and 138 patients into cohort 2. All admissions from 12/2019 to 05/2020 to the Division of Gastroenterology/Hepatology at the Vienna General Hospital were analyzed. Results: Thirty-two point six percent (n=91/279) of cohort 1 and 72.5%(n=95/131) of cohort 2 had tele-medical contact, while 59.5%(n=166/279)and 68.2%(n=90/132) had face-to-face visits. 24.1%(n=32/133) needed acute medical help during healthcare restrictions, however, 57.3%(n=51/89) reported that contacting their physician during COVID-19 was difficult or impossible. Patient-reported satisfaction with treatment decreased significantly during restrictions in cohort 1 (visual analog scale[VAS] 0-10:9.0+/-1.6 to8.6+/-2.2;p<0.001) and non-significantly in cohort 2 (VAS0-10:8.9+/-1.6 to8.7+/-2.1;p=0.182).Despite fewer hospital admissions during COVID-19, the proportion of non-elective admissions (+6.3%) and ICU-admissions (+6.7%) increased. Cirrhotic patients with non-elective admissions during COVID-19 had significantly higher MELD (25.5[14.2]vs.17.0[IQR:8.8]; p=0.003) and DeltaMELD(difference to last MELD;3.9+/-6.3vs.8.7+/-6.4;p=0.008), required immediate intensive care more frequently (26.7%vs.5.6%;p=0.034) and had significantly increased 30-day liver-related mortality (30.0%vs.8.3%;p=0.028). Conclusions: The COVID-19 pandemic impacts on quality of liver care as evident from decreased patient satisfaction, hospitalization of sicker ACLD patients and increased liver-related mortality. Strategies for improved tele-medical liver care and preemptive treatment of cirrhosis-related complications are needed to counteract the COVID-19-associated restrictions of in-hospital care.